Efficacy of different doses of corticosteroids on severe COVID-19 pneumonia

Objective: To investigate the efficacy of corticosteroids in the treatment of severe COVID-19 pneumonia at different doses. Methods: ： Between May 01, 2023, and June 20, 2023, 48 patients with severe COVID-19 pneumonia were treated in the Department of Respiratory and Critical Care Medicine of Jinan Fourth People's Hospital. The observation group (21 patients) received usual care plus high dose corticosteroids，below referred to as the high-dose group. The control group (27 patients) received usual care plus low-dose corticosteroids. Below referred to as the low-dose group. We collected baseline data, inflammatory markers after 3 days of treatment, body temperature recovery time, length of stay and 28-day all-cause mortality. The results of outpatient follow-up were recorded after 1 month. Result: There were no significant differences in 28-day mortality and length of stay. The number of days that body temperature returns to normal in high-dose group was shorter than low-dose group. The high-dose group was significantly better than low-dose group in reducing inflammatory factors (CRP IL-6). 20 discharged patients were given corticosteroid ranging from 8~16mg of methylprednisolone, depending on chest computed tomographic(CT) and clinical symptoms, after 1 month, in all discharged patients of use oral corticosteroid, the consensus was that the CT features had improved. Conclusion: The high-dose corticosteroids have a positive significance for the reduction of inflammatory factors and the shortening of body temperature recovery time. In the treatment of severe COVID-19 pneumonia, we can try early high-dose, short-course corticosteroids.