Background: The coronavirus disease 2019 (COVID-19) outbreak has posed significant public health issues and its secondary systemic inflammatory response is linked to the viral aggravation so glucocorticoids being with anti-inflammatory properties were utilized to treat severe cases characterized by the cytokine storm. Glucocorticoids, on the other hand, are a double-edged sword, since high doses can cause secondary infection and long-term significant consequences, as well as lengthen virus clearance time. Nonetheless, the risks and benefits of glucocorticoid adjuvant therapy for COVID-19 are inconclusive.
Objective: To assess the effect of methylprednisolone on the outcomes of severe COVID-19 cases at Ain Shams University hospitals from 1st of June 2020 to 31st of August 2020.
Methods: This is a retrospective cohort study involving 110 cases admitted to Ain Shams University hospitals with severe COVID-19 from 1st of June 2020 to 31st of August 2020. Retrospective evaluation of medical records was used to collect data. The study included males and females who were over 45 years old and presented as severe cases that were managed with steroid doses of 0.75-1.5 mg/kg/d. Data extracted included monitoring the patient's vital signs and oxygenation as well as imaging and regular blood tests like C-reactive protein, LDH, and ferritin and patient clinical outcomes whether discharge or death.
Results: Using data collection at Ain Shams University hospitals, a total of 110 severe and critically ill COVID-19 patients were included in this study between 1st of June 2020 to 31st of August 2020. Which showed that methylprednisolone decreased CRP, improved oxygen saturation of cases (p<0.001), reduce the need for mechanical ventilation (p<0.001) and decreased in-hospital mortality [48/110 (44%)].
Conclusion: Methylprednisolone treatment at a dose of 0.75-1.5 mg/kg/d for severe cases improves prognosis in severe COVID-19 patients.