Dexamethasone in Treatment of Comorbid SARS-CoV-2 Patients Aged over 50 Years with Lung Injury over 50 %

Aim. An efficacy assessment of steroid therapy in SARS-CoV-2 patients aged over 50 years with lung damage over 50 % (grade 3–4).Materials and methods. A retrospective study of 158 SARS-CoV-2 patients hospitalised in April—June 2020 was conducted under the inclusion criteria: age over 50 years, chest...

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Main Authors: O. Yu. Zolnikova, R. V. Maslennikov, V. T. Ivashkin, N. L. Dzhakhaya, O. Yu. Kiseleva, N. D. Potskhverashvili, S. A. Shorokhova
Format: Article
Language:Russian
Published: Gastro LLC 2021-10-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/600
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Summary:Aim. An efficacy assessment of steroid therapy in SARS-CoV-2 patients aged over 50 years with lung damage over 50 % (grade 3–4).Materials and methods. A retrospective study of 158 SARS-CoV-2 patients hospitalised in April—June 2020 was conducted under the inclusion criteria: age over 50 years, chest computed tomography (CT) for COVID-19-asso-ciated pneumonia, C-reactive protein (CRP) >50 mg/L, anticoagulant therapy, no contraindications to steroids, no biologic therapy. Cohort 1 patients (n = 96) received dexamethasone 4–12 mg/day, cohort 2 (n = 62) — a standard non-dexamethasone therapy.Results. Dexamethasone treatment associated with a significant alleviation of COVID-19-associated pneumonia in CT score (p = 0.001), reduced fibrinogen (p = 0.001), a trend to CRP reduction by day 8–10 and lower demand for oxygen therapy, including ventilatory support (p = 0.001). Mortality rate was 19.8 and 75.8 % in cohorts 1 and 2, respectively (p = 0.001).Conclusion. Dexamethasone therapy 4–12 mg/day in SARS-CoV-2 patients aged 50+ years with grade 3–4 CT changes receiving LMWH from start of hospitalisation significantly improved CT scores and reduced mortality.
ISSN:1382-4376
2658-6673