Effect of systemic corticosteroid on pulmonary function and survival of severe COVID-19 with COPD

This study aimed to evaluate the effect of different dose and initiating time of systemic corticosteroid on severe COVID-19 with chronic obstructive pulmonary disease (COPD). The study included severe COVID-19 with COPD group and severe COVID-19 group. Pulmonary function and 3-month survival were analyzed and compared. The results showed initiating systemic corticosteroid therapy in 1–7 days after diagnosed with COVID-19 can improve the FEV1%, DLco%, lung fibrosis score and 3-month survival, especially in severe COVID-19 with COPD patients (P = 0.0010, P = 0.0001, P = 0.0000 and P = 0.0001, respectively). ≥6mg dexamethasone injection daily in the 1st week of corticosteroid therapy can improve the DLco%, lung fibrosis score and 3-month survival, especially in COPD patients (P = 0.0458, P = 0.0013 and P = 0.0004, respectively). The 3-month survival of severe COVID-19 with COPD patients was higher than that of non-COPD patients (Log-rank: P = 0.0018), while the initiating time of systemic corticosteroid therapy was earlier (7.17 ± 5.70 days VS 10.12 ± 5.78 days, P = 0.0000) and the 1st week corticosteroid dose was higher (46.41 ± 26.56 mg VS 38.49 ± 31.56 mg, P = 0.0142). In conclusion, severe COVID-19 with COPD patients can have satisfied clinical outcomes if initiating systemic corticosteroid therapy in an early time (1–7 days after diagnosed with COVID-19) with enough dose (≥ 6mg dexamethasone injection daily).