Effects of Anticoagulants and Corticosteroids therapy in patients affected by severe COVID-19 Pneumonia

Effects of Anticoagulants and Corticosteroids therapy in patients affected by severe COVID-19 Pneumonia

Publication date: Jun 28, 2020

Background In the absence of a standard of treatment for COVID-19, the combined use of anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs may be more effective than using either modality alone in the treatment of COVID-19. Methods Patients hospitalized between April 10th, 2020, through May 10th, 2020, who had confirmed COVID-19 infection with clinical or radiographic evidence of pneumonia, in which 65 patients have moderate COVID-19 pneumonia, and 63 patients have severe COVID-19 pneumonia. All patients received early combination therapy of anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs. They assessed for type and duration of treatment, and days need to wean from oxygen therapy, length of stay, virus clearance time, and complication or adverse events. All patients had more than 28 days follow up after discharge from the hospital. Results Moderate COVID-19 pneumonia group were 65 patients who received Enoxaparin, antiviral drugs, empirical antibiotics for pneumonia, and standard treatment for comorbidity. Male patients were 50 (76.9 %) and female patients were 15 (23.1 %). 34 (52.3 %) patients have comorbidity, 25 (38.5%) patients have Diabetes Mellitus and 2 (3.1 %) pregnant ladies. 19 (29.2 %) patients were on low flow oxygen therapy, 3L oxygen or less to maintain oxygen saturation more than 92%. All patients discharged home with no major or minor bleeding complications or significant complications. Severe COVID-19 pneumonia group were 63 patients who received methylprednisolone, enoxaparin, antiviral drugs, empirical antibiotics for pneumonia, and standard treatment for comorbidity. Male patients were 55 (87.3 %) and female patients were 8 (12.7 %). 37 (58.7 %) patients have comorbidity, and 24 (38.1%) patients have Diabetes Mellitus. 32 (50.8 %) patients were on low flow oxygen therapy, 4-9L oxygen, and 31 (49.2 %) patients were on low flow oxygen therapy, 10L oxygen or more, including 12 patients on a non-rebreathing mask. Patients received methylprednisolone were 37 (58.7 %) for 3 days, 16 (25.4 %) for 5 days and 10 (15.9 %) for more than 5 days. Sixty-two patients discharged home with one patient had a long stay, and the other two transferred to ICU. One long-stay patient transferred to ICU on low flow oxygen therapy. Conclusion Early use of a combined anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs treatment in patients with moderate to severe COVID-19 pneumonia prevent complications of the disease and improve clinical outcomes.

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Concepts Keywords
Abdul Momin Renal replacement therapy
Air Oxygen therapy
Ambient Chemotherapy
Antibiotics Antibiotics
Antiviral Drug Phases viremia
Antiviral Drugs Home patient diabetes
ARDS Organ dysfunction
Assay Steroid early infection
Bleeding Infectious diseases
Chain Reaction Oxygen presence dyspnea
Chemotherapy Week illness
China Diabetes Mellitus
Combination Therapy Conscious pulmonary rehabilitation
Comorbidity SARS infection
Coronavirus COVID exertional dyspnea
Corticosteroids Hypothesis illness
Emergency Department Pulmonary micro thrombosis
Fatality Severe hyper inflammation
Hospital Severity inflammation
Immunocompromised Marked hyper inflammation
Infection Pulmonary involvement
Infectious Diseases Exertional dyspnea
Influenza Pneumonia
Informed Consent Medicine
Intensive Care Medical specialties
Intubation Clinical medicine
Irshad Infectious diseases
Madinah Intensive care medicine
Mechanically Ventilated RTT
Mellitus Medical emergencies
MERS Respiratory therapy
Methylprednisolone Pneumonia
Modality Sepsis
Nasopharyngeal Comorbidity
Oxygen Cellular telephone
Oxygen Saturation Chemotherapy
Oxygen Therapy
PCR
Pneumonia
Pulse Oximetry
QPCR
Radiographic
Rebreathing
Refractory
Renal
Respiratory Failure
SARS
Saudi Arabia
Steroids
Syndrome
Treating SARS
Vaccine
Virus
Wuhan
Zainab

Semantics

Type Source Name
disease MESH Pneumonia
drug DRUGBANK Enoxaparin
disease MESH infection
drug DRUGBANK Oxygen
disease MESH comorbidity
disease MESH Diabetes Mellitus
disease MESH bleeding
disease MESH complications
drug DRUGBANK Methylprednisolone
disease MESH Infectious Diseases
disease MESH emergency
disease MESH influenza
disease MESH Sepsis
disease MESH critically ill
disease MESH acute respiratory distress syndrome
disease MESH respiratory failure
disease MESH syndrome
disease MESH shock
disease MESH cancer
disease MESH renal
drug DRUGBANK Medical air
drug DRUGBANK Hydroxychloroquine
drug DRUGBANK Lopinavir
drug DRUGBANK Ritonavir
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH Death
drug DRUGBANK Azithromycin
disease MESH septic shock
disease MESH hyperglycemia
disease MESH pneumocystis pneumonia
disease MESH fibrosis
disease MESH hypoxemia
disease MESH viremia
disease MESH risk factors
disease MESH inflammation
drug DRUGBANK Tocilizumab
disease MESH macrophage activation syndrome
disease MESH lymphopenia
disease MESH thrombosis
disease MESH contraindications

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