Study On The Effect Of Low-dose Corticosteroid Therapy In The Treatment Of Non-critical Patients Infected With Corona Virus Disease-19

Objective:To investigate the effect of low-dose corticosteroid therapy in the treatment of non-critical patients infected with Corona Virus Disease-19.Method:We retrospectively reviewed 127 non-critical COVID-19 patients from the first Affiliated hospital of Nanchang University between January 2020 and March 2020.Accoroding to the use of corticosteroid therapy,65 were included in the experimental group(corticosteroid therapy combined with routine therapy)while 62 were included in the control group(routine therapy alone).According to the severities of the disease,7 were included in the mild group,86 were included in the normal group and 34 were included in the severe group.Hospitalization days,virus clearance days,symptom improvement days and blood glucose were compared between the two groups.Meanwhile,a subgroup analysis was performed in terms of the severities to observe the endpoints.Result:Of 127 patients,65(51.2%)received corticosteroid therapy.Compared to the normal group,the severe group had longer usage days of methylprednisolone(11.4 d vs 5.9 d,P<0.001).The dose of methylprednisolone of normal group was 0.49 mg/(kg·d)while severe group was 0.40 mg/(kg·d).Compared with normal patients who did not receive corticosteroid therapy,normal patients who received corticosteroid therapy had more hospitalization days(16.0 d vs 11.0 d,P=0.054),more virus clearance days(13.0 d vs 9.0 d,P<0.029)and longer fever days(8.0 d vs 5.0 d,P=0.005),similar symptom improvement days and higher blood glucose(8.83 mmol/L vs 6.63 mmol/L,P<0.001).For severe patients,experimental group had more hospitalization days(18.5 d vs 11.0 d,P=0.007),less first symptom improvement days(9.5d vs 11.5d,P<0.05)while similar virus clearance days(16.5 d vs 15.0 d,P=0.843)and blood sugar level(10.6 vs 9.31 mmol/L,P<0.364).Conclusion:Low-dose corticosteroid therapy in severe patients with COVID-19 was not associated with delayed virus clearance and longer end symptom improvement days,but was associated with longer hospitalization days and shorter first symptom improvement days.Normal patients with COVID-19 could not gain clinical benefits with low-dose corticosteroid therapy.