Corticosteroid effectiveness among hospitalised COVID-19 patients in Malaysia

Introduction: Using steroids to manage hospitalised coronavirus disease 2019 (COVID-19) patients caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has been shown to reduce the need for mechanical ventilation and mortality. To date, low-dose dexamethasone and methylp...

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Bibliographic Details
Published in:	Journal of infection in developing countries Vol. 16; no. 9; pp. 1390 - 1397
Main Authors:	Kori, Najma, Islahudin, Farida, Abd Rahim, Muhammad Yusuf Zawir, Periyasamy, Petrick, Mohamed Shah, Noraida, Md Hatah, Ernieda, Lan, Lau Chee
Format:	Journal Article
Language:	English
Published:	Sassari Journal of Infection in Developing Countries 01-09-2022
Subjects:	Clinical outcomes Coronaviruses COVID-19 Severe acute respiratory syndrome coronavirus 2 Steroids
Online Access:	Get full text
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Summary:	Introduction: Using steroids to manage hospitalised coronavirus disease 2019 (COVID-19) patients caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has been shown to reduce the need for mechanical ventilation and mortality. To date, low-dose dexamethasone and methylprednisolone corticosteroids have been effective in reducing the infection’s progress in hospitalised patients. However, it is unknown if high dosages of corticosteroids can achieve a better clinical outcome. This study aims to compare the clinical outcomes of hospitalised COVID-19 patients who are given a 10-day low-dose corticosteroid treatment (IV 2 mg/kg/day methylprednisolone loading dose (LD) then 0.25 mg/kg four times a day (q.i.d.)) with patients given a 10-day high-dose corticosteroid treatment (IV 20 mg dexamethasone once daily (o.d.) or a 1.5 mg/kg prednisolone tablet o.d.). Methodology: Retrospective data on hospitalised COVID-19 patients were collected for this study, and the primary outcome measure was the patients’ clinical status based on the World Health Organization’s (WHO) Ordinal Scale for Clinical Improvement (OSCI) on Day-5 and Day-10 post-steroid. Results: The results demonstrated that using steroids significantly improved patients’ clinical outcomes from a WHO OSCI level of 4 (0.1) on Day-1 to 2.6 (2.5) on Day-5 (p < 0.001). There was no significant difference in clinical outcome between low-dose and high-dose corticosteroid treatment on Day-5 (H = 2.15; p = 0.34) and Day-10 (H = 1.12; p = 0.58). Conclusions: This study concludes that using low-dose corticosteroids is recommended for hospitalised COVID-19 patients to ensure clinical outcomes are optimised.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1972-2680 2036-6590 1972-2680
DOI:	10.3855/jidc.16039