High pulse dose steroids in Severe COVID-19 pneumonitis refractory hypoxemia to dexamethasone

Methylprednisolone (MD) in pulse dosage of 1g once a day for three days was given to 12 patients with severe COVID-19 pneumonitis with refractory hypoxemia to dexamethasone low dosage of 10 days. Decision to give Solu medrol was based on expert multidisciplinary opinion with back-up papersThe most prominent comorbidities in the study group was obesity. 10 out of 12 patients were obese with an average BMI of 37 (BMI minimal 31.3 and max 43).Furthermore hypertension (67%), diabetes mellitus type 2 (33%), OSAS (25%), asthma (1 patient), pre-existing pulmonary embolism (1 patient), colon malignancy (1 patient) and alcohol liver cirrhosis (1 patient) were also amongst the comorbidities of the study group. Table 1Imaging was performed at admission, XRray and in most of the patients CT-of the chest. In all the patient diffuse ground glass opacities bilateral with consolidation were observed. Acute Pulmonary embolism (PE) was ruled out in all patientCRP of the patients were obtained on the day before giving the MD dose and on the date of discharge either from the hospital of step down from the ICU. It was seen that the CRP decreased significantly in all the patients that were able to be discharged.It was observed that these patient who had refractory hypoxia to dexamethasone due to severe COVID-19 pneumonitis, with the need to be admitted to the ICU for Optiflow or ventilation, the application of pulse dose methylprednisolone 1gr for 3days was beneficial as these patients were succes...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical problems Source Type: research