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Impact of dexamethasone on SARS-CoV-2 concentration kinetics and antibody response in hospitalized COVID-19 patients: results from a prospective observational study.
Mühlemann, Barbara; Thibeault, Charlotte; Hillus, David; Helbig, Elisa T; Lippert, Lena J; Tober-Lau, Pinkus; Schwarz, Tatjana; Müller, Marcel A; Witzenrath, Martin; Suttorp, Norbert; Sander, Leif E; Drosten, Christian; Jones, Terry C; Corman, Victor M; Kurth, Florian.
  • Mühlemann B; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Thibeault C; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.
  • Hillus D; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.
  • Helbig ET; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.
  • Lippert LJ; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.
  • Tober-Lau P; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.
  • Schwarz T; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany.
  • Müller MA; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Witzenrath M; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; German Centre for Lung Research (DZL), Gießen, Germany.
  • Suttorp N; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; German Centre for Lung Research (DZL), Gießen, Germany.
  • Sander LE; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; German Centre for Lung Research (DZL), Gießen, Germany.
  • Drosten C; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Jones TC; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge CB2 3EJ, UK.
  • Corman VM; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany; German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Kurth F; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Department of Medicine I,
Clin Microbiol Infect ; 27(10): 1520.e7-1520.e10, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1297038
Semantic information from SemMedBD (by NLM)
1. 2019 novel coronavirus LOCATION_OF dexamethasone
Subject
2019 novel coronavirus
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LOCATION_OF
Object
dexamethasone
2. Upper respiratory tract LOCATION_OF 2019 novel coronavirus
Subject
Upper respiratory tract
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LOCATION_OF
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2019 novel coronavirus
3. Antibody Formation PROCESS_OF Patients
Subject
Antibody Formation
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PROCESS_OF
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Patients
4. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
5. Upper respiratory sample PART_OF Tract
Subject
Upper respiratory sample
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PART_OF
Object
Tract
6. Reverse Transcriptase Polymerase Chain Reaction MEASURES Upper respiratory sample
Subject
Reverse Transcriptase Polymerase Chain Reaction
Predicate
MEASURES
Object
Upper respiratory sample
7. Specimen Type - Serum LOCATION_OF immunoglobulin G
Subject
Specimen Type - Serum
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LOCATION_OF
Object
immunoglobulin G
8. dexamethasone ADMINISTERED_TO Patients
Subject
dexamethasone
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ADMINISTERED_TO
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Patients
9. dexamethasone compared_with dexamethasone
Subject
dexamethasone
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compared_with
Object
dexamethasone
10. dexamethasone TREATS Virus
Subject
dexamethasone
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TREATS
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Virus
11. 2019 novel coronavirus LOCATION_OF dexamethasone
Subject
2019 novel coronavirus
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LOCATION_OF
Object
dexamethasone
12. Upper respiratory tract LOCATION_OF 2019 novel coronavirus
Subject
Upper respiratory tract
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LOCATION_OF
Object
2019 novel coronavirus
13. Antibody Formation PROCESS_OF Patients
Subject
Antibody Formation
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PROCESS_OF
Object
Patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
Object
Patients
15. Upper respiratory sample PART_OF Tract
Subject
Upper respiratory sample
Predicate
PART_OF
Object
Tract
16. Reverse Transcriptase Polymerase Chain Reaction MEASURES Upper respiratory sample
Subject
Reverse Transcriptase Polymerase Chain Reaction
Predicate
MEASURES
Object
Upper respiratory sample
17. Specimen Type - Serum LOCATION_OF immunoglobulin G
Subject
Specimen Type - Serum
Predicate
LOCATION_OF
Object
immunoglobulin G
18. dexamethasone ADMINISTERED_TO Patients
Subject
dexamethasone
Predicate
ADMINISTERED_TO
Object
Patients
19. dexamethasone compared_with dexamethasone
Subject
dexamethasone
Predicate
compared_with
Object
dexamethasone
20. dexamethasone TREATS Virus
Subject
dexamethasone
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TREATS
Object
Virus
ABSTRACT

OBJECTIVES:

Dexamethasone has become the standard of care for severe coronavirus disease 2019 (COVID-19), but its virological impact is poorly understood. The objectives of this work were to characterize the kinetics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) concentration in the upper respiratory tract (URT) and the antibody response in patients with (D+) and without (D-) dexamethasone treatment.

METHODS:

Data and biosamples from hospitalized patients with severe COVID-19, enrolled between 4th March and 11th December 2020 in a prospective observational study, were analysed. SARS-CoV-2 virus concentration in serial URT samples was measured using RT-PCR. SARS-CoV-2-specific immunoglobulins A and G (IgA and IgG) were measured in serum samples using S1-ELISA.

RESULTS:

We compared 101 immunocompetent patients who received dexamethasone (according to the inclusion criteria and dosage determined in the RECOVERY trial) to 93 immunocompetent patients with comparable disease severity from the first months of the pandemic, who had not been treated with dexamethasone or other glucocorticoids. We found no inter-group differences in virus concentration kinetics, duration of presence of viral loads >106 viral copies/mL (D+ median 17 days (IQR 13-24), D- 19 days (IQR 13-29)), or time from symptom onset until seroconversion (IgA D+ median 11.5 days (IQR 11-12), D- 14 days (IQR 11.5-15.75); IgG D+ 13 days (IQR 12-14.5), D- 12 days (IQR 11-15)).

CONCLUSION:

Dexamethasone does not appear to lead to a change in virus clearance or a delay in antibody response in immunocompetent patients hospitalized with severe COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Dexamethasone / SARS-CoV-2 / COVID-19 / Antibodies, Viral Type of study: Observational study / Randomized controlled trials Limits: Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2021 Document Type: Article Affiliation country: J.cmi.2021.06.008

Full text: Available Collection: International databases Database: MEDLINE Main subject: Dexamethasone / SARS-CoV-2 / COVID-19 / Antibodies, Viral Type of study: Observational study / Randomized controlled trials Limits: Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2021 Document Type: Article Affiliation country: J.cmi.2021.06.008