Efficacy of pulse steroid therapy in patients critically ill with COVID-19.

OBJECTIVES: The aim of this study was to determine the efficacy of pulse steroid therapy administered to patients critically ill with COVID-19 progressing into severe pneumonia. METHODS: A total of 600 patients included in this retrospective study were divided into three groups. Group 1 (control group): 200 patients who did not receive steroid treatment, Group 2: 200 patients who received dexamethasone 1x8 milligram (mg) or methylprednisolone 1x80 mg, Group 3: (pulse steroid therapy group): 200 patients who received 1 g methylprednisolone followed by 1x80 mg methylprednisolone. Demographic and laboratory data were recorded. RESULTS: Mortality rates in groups 1, 2 and 3 were 77 %, 53.55 %, and 58.5 %, respectively. The ratios of intubated patients in groups 1, 2 and 3 were 70 %, 45.5 % and 56 %, respectively. The numbers of patients whose D­dimer values were above 2,250 ng/mL (cut-off value for D-dimer in this study) in groups 2, 1 and 3 were 65, 107, and 105, respectively. CONCLUSION: Pulse steroid therapy does not shorten the duration of hospital stay, does not reduce the need for intubation and increases the risk of thrombosis by significantly increasing the level of D-dimer among patients critically and severely ill with COVID-19 (Tab. 4, Fig. 3, Ref. 20) Keywords: COVID-19, pulse steroid therapy, thrombosis, d-dimer, corticosteroid.

Socio-economic impacts of COVID-19 in a one health context

The last decades experienced a significant increase in the number of infectious disease outbreaks while current economic systems put pressure on the environment and wildlife is being destructed, leading to species to live closer to each other and humans. These diseases including zoonoses cause loss of life and threaten economic development and the integrity of the ecosystems. The recent COVID-19 is a significant example of this situation with a dramatic loss of human life, devastating economies and causing social disruption. The COVID-19 pandemic has also threatened food security, putting millions of people at risk of hunger, disrupted food, and feed supply routes, put pressure on livestock industries, led to a decrease in world meat production, caused trade restrictions, changed consumer habits, affected animal health and animal welfare. In this study, the main drivers of zoonoses, socio-economic impacts of these zoonoses with an emphasis on the COVID-19 pandemic and the necessary actions that need to be taken to prevent further epidemics/pandemics have been discussed in the context of "One Health" approach.