Open AccessDexamethasone in Treatment of Comorbid SARS-CoV-2 Patients Aged over 50 Years with Lung Injury over 50 %
Author(s) -
O. Yu. Zolnikova,
Roman Maslennikov,
В. Т. Ивашкин,
Н. Л. Джахая,
Olga I. Kiseleva,
Н. Д. Поцхверашвили,
С. А. Шорохова
Publication year - 2021
Publication title -
rossijskij žurnal gastroènterologii, gepatologii, koloproktologii
Language(s) - English
Resource type - Journals
eISSN - 2658-6673
pISSN - 1382-4376
DOI - 10.22416/1382-4376-2021-31-3-43-50
Subject(s) - medicine , dexamethasone , oxygen therapy , pneumonia , cohort , retrospective cohort study , anticoagulant therapy , gastroenterology , cohort study , mortality rate , surgery
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.