Clinical observation of glucocorticoids application in patients with severe coronavirus disease 2019 (COVID-19): a descriptive study

Abstract Background The coronavirus disease 2019 (COVID-19) caused an ongoing pandemic and bring heavy burden globally. We retrospectively investigated the effect of glucocorticoids on clinical symptoms, course of disease, and negative change of nucleic acid detection in patients with severe COVID-19. Methods Individual demographics data, CT images, clinical outcomes, laboratory investigations, treatment of patients with severe COVID-19 were collected from electronic medical records of the Central Hospital of Wuhan, from January 28 to February 28, 2020. Results Eighteen severe cases of COVID-19 received low-dose of glucocorticoid treatments. They were initially treated with 40 mg methylprednisolone with gradually reduced doses and changed into oral prednisolone. The courses of glucocorticoid treatments ranged from 4 to 30 days. The pulmonary infections were absorbed to different degrees in 16 cases, one case deteriorated in CT imaging and one had no significant change. All cases had fever regression. Fifteen cases could respire without oxygen supply. Two were still inhaled oxygen through nasal catheters and one with high flow oxygen gradually transferred to face mask for oxygen supply. Five cases discharged. Twelve cases who were in stable conditions for treatment remained in hospital. One case was still in critical condition. The results of three re-examinations of SARS-Cov-2 nucleic acids by RT-PCR were negative. Conclusions The early use of low-dose glucocorticoid therapy in severe COVID-19 infection may have a positive effect on the prevention and treatment of disease deterioration.