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.
Subject(s)
COVID-19 , Fever , Pulmonary EmbolismABSTRACT
Background The coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, and soon caused an ongoing pandemic globally. In this study we conducted a retrospective study to evaluate the safety and efficacy of combined spinal-epidural anaesthesia (CSEA) and infection control measures on perinatal care quality of 30 pregnant women with confirmed and suspected COVID-19. Methods Individual demographic data, clinical outcomes, laboratory investigations of pregnant women and their newborns were collected from electronic medical records of the Maternal and Children Health Hospital of Hubei Province, during January 24 to February 29, 2020. Anaesthesia and surgery results were compared between pregnant women with confirmed and suspected COVID-19 infection. Results Using CSEA in cesarean section was effective and safe for pregnant women with confirmed and suspected COVID-19 infection. Administration of dezocine and morphine was effective as postoperative analgesia, and well tolerated in COVID-19 patients. The assessment of surgery outcomes also showed similar results in both confirmed and suspected cases. No respiratory failure nor distress were found in the mothers with confirmed COVID-19 infection and their neonates. None of these patients experienced severe obstetric complications related to anaesthesia and surgeries. No COVID-19 infection was reported in the neonates born to the mothers with confirmed COVID-19 infection and healthcare workers in these operations. Conclusions In cesarean section for pregnant women with COVID-19 infection, CSEA was safe and efficient in achieving satisfactory obstetrical anaesthesia and postoperative analgesia. No cross-infection occurred in the HCWs working in these operations.