Endocrine Abstracts

Background: Corticosteroids suppress the immune system and have been proposed as a treatment for the severe form of (COVID-19) due to their potential ability to inhibit the COVID-19-induced cytokine storm. We aimed to evaluate the effects of cumulative doses of corticosteroids on the recovery of COVID-19 patients.

Methods: In this descriptive cross-sectional study, we retrospectively evaluated patients with COVID-19 (confirmed by [PCR]) receiving corticosteroids at Shahid Mohammadi Hospital, Bandar Abbas, Iran during June-October 2020. All patients had been admitted to the general wards and not the intensive care unit. COVID-19 was not severe in any of the patients. Beside corticosteroids, all patients had received similar standard COVID-19 treatment according to the National COVID-19 Committee protocols. In addition to the demographic features of the patients including age and gender, COVID-19 symptoms, respiratory rate (RR), lactate dehydrogenase (LDH) level, C-reactive protein (CRP) level, oxygen saturation (SpO2), lymphocyte percentage and count on admission and at the last evaluation before discharge were extracted from the patients’ medical files.

Results: A total of 200 patients with confirmed COVID-19 were included in this study. The mean age of the patients was 51.65±9.35 years and 117 (58.5%) were male. The administered corticosteroid was dexamethasone in 55%, methylprednisolone in 32.5%, and prednisolone in 12.5%. The mean administered cumulative corticosteroid dose was equal to 82.69±59.40 mg prednisolone. All COVID-19 symptoms, including fever, cough, dyspnea, headache, body ache, and anosmia decreased in the patients. However, there was no significant difference between patients using < 65 mg of corticosteroids and those using ≧ 65 mg of the medicine regarding the final status of symptoms. The increase in SpO2 was significantly higher in patients using < 65 mg of corticosteroids (P=0.008). Moreover, the proportion of patients with negative final CRP was significantly higher in this group (P< 0.001). On the contrary, hospital length of stay was significantly shorter in patients using ≧ 65 mg of corticosteroids (P=0.034). The two groups had no significant differences in terms of LDH levels, lymphocyte percentage and count, RR, and the final status of lung infiltration (P> 0.05).

Conclusions: While the cumulative dose of corticosteroids equal to < 65 mg of prednisolone is associated with increased SpO2 and decreased CRP in COVID-19 patients, it leads to prolonged hospital stay compared to the ≧ 65 mg dose of corticosteroids.