ABSTRACT
Background/Introduction: The use of oral and intravenous corticosteroids as a treatment for SARS-CoV-2 infection has been shown to inhibit the exaggerated inflammatory response, reducing symptoms and days of hospitalization of patients. However, its use is controversial because not enough clinical studies have been made to verify the safety of the drugs. Objective/Aim: To assess the safety profile of glucocorticoid treatment, at high and low doses, in suspected and/or confirmed patients with COVID-19 at the Ignacio Chavez National Institute of Cardiology, determining the most frequent side effects in patients, and assessing whether the administration of the drugs represents a greater benefit than the risk of presenting these effects. Methods: 366 patients were evaluated and divided into 3 groups: use of methylprednisolone (155 mg average) every 24 h for 3 days, dexamethasone (6 mg) every 24 h for 10 days, and patients with no use of corticosteroids. 87 patients in the study where excluded for meeting exclusion criteria. Hyperglycemia was evaluated in terms of its harshness and severity in relation to the maximum glucose level that the patients presented during the first 10 days after the start of treatment. Drug-associated hyperglycemia was not considered in patients admitted with hyperglycemic uncontrolled levels greater than 200 mg/dL Results: We observed that the cumulative incidence of hyperglycemia in the group with high doses of corticosteroids (methylprednisolone 155 mg day average) is 70%, low doses of corticosteroids (Dexamethasone 6 mg/day) is 67% and that of the group without corticosteroids is 31%. Based on the results or the 95% confidence interval calculation for estimating the risk of infections and hyperglycemia after the use of methylprednisolone and dexamethasone in the patients evaluated, it was observed that there is a risk of these effects occurring after the use of corticosteroids. However, it is not possible to define whether the use of any of the drugs represents a greater risk within this group of drugs, since the interval between the two groups of drugs is similar. Conclusion: The use of glucocorticoids at high and low doses as a treatment for COVID-19 disease has been shown to be effective in reducing symptoms and days of hospitalization in these patients. However, based on the results obtained, it was concluded that the use of these drugs can cause changes in the basal glucose of patients, in addition to increasing the risk of contracting in-hospital infections due to immunosuppression secondary to the use of glucocorticoids.