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Observational Study
. 2020 May;212(9):416-420.
doi: 10.5694/mja2.50577. Epub 2020 Apr 8.

Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19)

Lei Zha  1 , Shirong Li  2 , Lingling Pan  3 , Boris Tefsen  1 , Yeshan Li  2 , Neil French  4 , Liyun Chen  5 , Gang Yang  2 , Elmer V Villanueva  1
Affiliations
Observational Study

Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19)

Lei Zha et al. Med J Aust. 2020 May.

Abstract

Objectives: To assess the efficacy of corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19).

Design, setting: Observational study in the two COVID-19-designated hospitals in Wuhu, Anhui province, China, 24 January - 24 February 2020.

Participants: Thirty-one patients infected with the severe acute respiratory coronavirus 2 (SARS-CoV-2) treated at the two designated hospitals.

Main outcome measures: Virus clearance time, length of hospital stay, and duration of symptoms, by treatment type (including or not including corticosteroid therapy).

Results: Eleven of 31 patients with COVID-19 received corticosteroid treatment. Cox proportional hazards regression analysis indicated no association between corticosteroid treatment and virus clearance time (hazard ratio [HR], 1.26; 95% CI, 0.58-2.74), hospital length of stay (HR, 0.77; 95% CI, 0.33-1.78), or duration of symptoms (HR, 0.86; 95% CI, 0.40-1.83). Univariate analysis indicated that virus clearance was slower in two patients with chronic hepatitis B infections (mean difference, 10.6 days; 95% CI, 6.2-15.1 days).

Conclusions: Corticosteroids are widely used when treating patients with COVID-19, but we found no association between therapy and outcomes in patients without acute respiratory distress syndrome. An existing HBV infection may delay SARS-CoV-2 clearance, and this association should be further investigated.

Keywords: Corticosteroids; Epidemics; Pneumonia, viral.

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