Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report

  • Jian Zhang
    Department of Infectious Diseases, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Zigang Tian
    Surgical Department of Tuberculosis, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Lina Feng
    Internal Medicine Department of Tuberculosis, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Zhongming Yang
    Internal Medicine Department of Tuberculosis, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Bo Zou
    Internal Medicine Department of Tuberculosis, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Kun Li
    Department of Pleurisy, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Yingliang Zhang
    Internal Medicine Department of Tuberculosis, Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123
  • Yaguo Wang
    Key Laboratory of RNA Biology and CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences , Beijing , China 100101
  • Joy Fleming
    Key Laboratory of RNA Biology and CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences , Beijing , China 100101
  • Wenyu Cui
    Changchun Infectious Diseases Hospital , Changchun , Jilin , China 130123

Description

<jats:title>Abstract</jats:title> <jats:p>Inflammation-mediated lung injury in severe cases of infection with SARS-CoV-2, the aetiological agent of Coronavirus disease 2019 (COVID-19), can lead to respiratory failure and death, and therapies that block or ameliorate lung injury-associated inflammatory “cytokine storms” and progression to acute respiratory distress syndrome (ARDS) are urgently needed. Therapeutic use of corticosteroids for this purpose has been controversial because of conflicting reports on their efficacy and immunosuppressive behaviour. The WHO has strongly recommended treating critical COVID-19 patients with systemic corticosteroid therapy, but recommends against corticosteroid therapy in non-severe COVID-19 disease because of a lack of strong evidence on its efficacy. This retrospective case report describing the successful treatment of a non-severe COVID-19 case in Changchun, China, by judicious administration of corticosteroids using a personalized therapeutic approach was recorded to strengthen the evidence base showing how corticosteroid use in non-severe COVID-19 cases can be safe and efficacious. Alongside supportive care and lopinavir/ritonavir antiviral drugs, a low dosage of methylprednisolone was administered over a short period to attenuate lung inflammation. Regular chest CT scans guided dosage reduction in response to lesion absorption and improved lung condition. Judicious use of corticosteroids safely attenuated disease progression and facilitated rapid and complete recovery.</jats:p>

Journal

  • Open Medicine

    Open Medicine 16 (1), 440-445, 2021-01-01

    Walter de Gruyter GmbH

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