Effectiveness of High-dose Steroids Treatment in Patients with Severe Presentation of Covid -19

Background and Aims: In the COVID 19 acute phase, low-dose steroids treatment has been proved to be effective, but studies on the effect of high-dose steroids are currently lacking. Here, we report our experience with high-dose steroids in a case-series of COVID-19 patients. Material and Methods: Patients admitted to the Unit of Internal Medicine of Cardarelli Hospital-Naples with severe COVID-19 presentation, defined by a P/F<250 and high CT score, with evidence of interstitial pneumonia receiving high-dose steroids therapy (Dexamethasone 20 mg/day for 5 days and 10 mg/day for other 5 days) were considered. For each case, we completed a case-report form including P/F ratio, radiologic score (24 fields score), calculated when high dose steroids were started and after 14 days. An unfavourable outcome was defined by intrahospital death. Results: Thirty-eight patients were included [Males 74%, median age 63 years (range 30-89)]. Comorbidities or high BMI were reported in 31 (82%) cases. Median radiologic score was 16 (range 10-23). After steroids were administered, we observed a significant improvement of P/F ratio (130 Vs 176, t=2.37, p=0.027) and of radiologic score. Mortality rate was 45%. Conclusions: High-dose steroids can be administered to patients with severe COVID-19, but do not affect mortality.

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