Corticosteroids, Covid19, Dexamethasone, SARS-CoV 2, Steroids
Conditions
Brief summary
The investigators reviewed the charts of SARS-CoV-2 patients with pneumonia and moderate to severely elevated CRP and worsening hypoxemia who were treated with early, short-term dexamethasone.
Interventions
DRUGDexamethasone
4mg dexamethasone was given to some patients three times daily for 2 days, 2 times daily for 2 days, once daily for 2 days.
Sponsors
The Miriam Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Moderate disease with at least a 30% increase in CRP within 36 hours of admission, and with increasing oxygen requirements. 2. All patients with severe disease with evidence of escalating oxygen requirements 3. The presence of secondary bacterial infections as a probable cause of increasing CRP levels was excluded in all selected patients. 4. Pulmonary embolism and /or cardiac dysfunction were excluded as probable causes of worsening hypoxia in all selected patients.
Exclusion criteria
1. All patients on other treatment modalities- Remdesivir and/or Convalescent plasma who showed evidence of clinical improvement as per decrease in CRP levels and/or oxygen requirements were excluded. 2. Patient with associated COPD exacerbation who would benefit from the use of steroids. 3. Patients with Diabetic ketoacidosis, hyperglycemic hyperosmolar state, active concurrent bacterial infections. 4. Patients with history of steroid-induced mania and/or psychosis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Effect on transfers to ICU and escalation of care needing mechanical ventilation | 2 months |
Secondary
| Measure | Time frame |
|---|---|
| Effect on length of stay | 2 months |
| Change in CRP levels | 2 months |
Countries
United States
Outcome results
None listed