Effect of glucocorticoid therapy on the prognosis of patients with severe and critical COVID-19: a single-center retrospective cohort study

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has elevated mortality in severe and critical patients globally. This study examined the effect of glucocorticoids (GCS) on the time of virus clearance and absorption of lung lesions in severe and critical COVID-19 patients. PATIENTS AND METHODS: From January 7th to February 10th, of the hospitalized patients in Wuhan Pulmonary Hospital. 66 patients diagnosed with severe and critical COVID-19 were analyzed. The generalized linear model was utilized to assess the effects of GCS therapy on the times of nucleic acid test turning negative and improved pulmonary imaging, respectively. RESULTS: Of 66 patients. 51 (77.3%) and 15 (22.7%) were severe and critical cases, respectively. and aged 62 +/- 11 years. A total of 58 patients (87.9%) tested negative. and 56 (84.8%) showed improved lung imaging. Age, thrombocytopenia, CD8 + T cell count, course of GCS therapy, and total dose were correlated with the time of nucleic acid test turning negative (p < 0.05), and sex was correlated with the time of initial pulmonary imaging improvement (p < 0.05). The time of nucleic acid test turning negative in individuals with GCS therapy courses <= 10 days was shorter than that of the GCS therapy course > 10 days group (p=0.001). No statistical difference was found in the dose, course of GCS, and initial time of improved lung imaging. CONCLUSIONS: Increasing the dose of GCS and prolonging the course of treatment do not shorten the time of nucleic acid test turning negative or improved absorption of pulmonary lesions. Thus, the rational use of GCS is particularly important.