Corticosteroids in the treatment of SARS-CoV-2 related lung disease

Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.

Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method.

Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.

Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.