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Effects of early corticosteroid use in patients with severe coronavirus disease 2019

 Jong Hoon Hyun  ;  Moo Hyun Kim  ;  Yujin Sohn  ;  Yunsuk Cho  ;  Yae Jee Baek  ;  Jung Ho Kim  ;  Jin Young Ahn  ;  Jun Yong Choi  ;  Joon Sup Yeom  ;  Mi Young Ahn  ;  Eun Jin Kim  ;  Ji-Hyeon Baek  ;  Young Keun Kim  ;  Heun Choi  ;  Su Jin Jeong 
 BMC INFECTIOUS DISEASES, Vol.21(1) : 506, 2021-05 
Journal Title
Issue Date
Adrenal Cortex Hormones / therapeutic use* ; Aged ; COVID-19 / diagnosis ; COVID-19 / drug therapy* ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Republic of Korea ; Respiratory Distress Syndrome ; Retrospective Studies
COVID-19 ; Coronavirus disease 2019 ; Corticosteroid ; Pneumonia ; SARS-CoV-2
Background: Coronavirus disease 2019 (COVID-19) is associated with acute respiratory distress syndrome, and corticosteroids have been considered as possible therapeutic agents for this disease. However, there is limited literature on the appropriate timing of corticosteroid administration to obtain the best possible patient outcomes.

Methods: This was a retrospective cohort study including patients with severe COVID-19 who received corticosteroid treatment from March 2 to June 30, 2020 in seven tertiary hospitals in South Korea. We analyzed the patient demographics, characteristics, and clinical outcomes according to the timing of steroid use. Twenty-two patients with severe COVID-19 were enrolled, and they were all treated with corticosteroids.

Results: Of the 22 patients who received corticosteroids, 12 patients (55%) were treated within 10 days from diagnosis. There was no significant difference in the baseline characteristics. The initial PaO2/FiO2 ratio was 168.75. The overall case fatality rate was 25%. The mean time from diagnosis to steroid use was 4.08 days and the treatment duration was 14 days in the early use group, while those in the late use group were 12.80 days and 18.50 days, respectively. The PaO2/FiO2 ratio, C-reactive protein level, and cycle threshold value improved over time in both groups. In the early use group, the time from onset of symptoms to discharge (32.4 days vs. 60.0 days, P = 0.030), time from diagnosis to discharge (27.8 days vs. 57.4 days, P = 0.024), and hospital stay (26.0 days vs. 53.9 days, P = 0.033) were shortened.

Conclusions: Among patients with severe COVID-19, early use of corticosteroids showed favorable clinical outcomes which were related to a reduction in the length of hospital stay.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Moo Hyun(김무현)
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Baek, Yae Jee(백예지)
Sohn, Yujin(손유진)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Cho, Yunsuk(조윤숙)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Hyun, Jong Hoon(현종훈) ORCID logo https://orcid.org/0000-0002-9621-0250
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