Endocrine Abstracts

Purpose : To determine the effective and safe regimen of glucocorticoids administration in patients with COVID-19 and with or without DM.

Materials and methods: We examined 276 patients with covid-19 and polysegmental pneumonia with CT (1-4) in inpatient treatment with an oxygen support level of up to 15 liters per minute, all patients were discharged from the hospital. Patients were divided into 2 groups according to the therapy they received. The first group of patients was treated with glucocorticoids (dexamethasone) - observational group of 205 patients, men -114, women -91 and the second was control group of 71 patient without glucocorticoid therapy: men -42, women -29. The number of patients with and without diabetes was assessed in each of the group. The observational group was divided into 3 subgroups according to the regimen of glucocorticoid therapy: in 1 subgroup of 68 patients dexamethasone was administered intravenous (i/v) once a day (the dose was 8 to 32 mg); in 2 subgroup patients received dexamethasone i/v 2 times a day (in a total daily dose of up to 32 mg) - 70 patients ; and in 3 subgroup of 67 patients dexamethasone was administered intramuscularly once daily (dose not less than 0.1 mg per 1 kg of body weight). In each subgroup number of patients with DM was assessed. All groups received standard therapy for COVID-19.

Results: in the observational subgroup of patients with DM at the end of the study Inflammatory factor such as: leukocytes increased by 35-41%, depending on the subgroup; the neutrophil-lymphocyte index (NLI) decreased by 28-44%; CRP decreased by 78.9-88.2% (p-0.001). In the subgroup of patients without DM, leukocytes decreased by 23-28%, NLI did not change, CRP decreased by 75-82.5% (p-0.01). In the Control group: no significant difference was obtained in the parameters of leukocytes, NLI. CRP decreased significantly in patients with DM by 39.7%, and without DM by 56.5% (p-0.0001).

Conclusions: 1) The optimal regimen of glucocorticoid therapy is a single-dose intravenous or intramuscular administration of dexamethasone not less than 0.1 mg per 1 kg of body weight. 2) А statistically reliable effective and safe dose for patients with diabetes mellitus is 12 mg, without diabetes mellitus 11-12 mg.