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

ABSTRACT

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.