A comparison of the Effects of Low and High Doses of Corticosteroids on Recovery of the Patients with Covid-19

SARS-CoV-2 is a new coronavirus type that first appeared in Wuhan, China, and caused a pandemic of respiratory diseases from the end of 2019. Severe infections of this virus can cause incorrect adjustments of cytokine and chemokine responses, which ultimately causes damage to the lung tissue. Corticosteroids are a class of drugs that reduce inflammation and immune system activities in the body. For this reason, many doctors and researchers thought of using corticosteroid treatments to control the cytokine storm.

In this retrospective descriptive cross-sectional study, the files of Covid-19 patients who were admitted to Shahid Mohammadi Hospital, Bandar Abbas, Iran, were examined. On the basis of the severity, the patients were grouped into two groups of moderate and severe patients. Patients in each group were then sub-categorized into high dose and low dose, according to the received dose of corticosteroids. Then we investigated the effect of different doses of corticosteroids on the course of recovery of Covid-19 cases.

In the severe group, the patients who received high-dose of corticosteroids had a higher mortality rate as compared to the low-dose group. In both the severe and moderate groups, the LDH level of the patients who received low doses of corticosteroids at the time of discharge were significantly less compared to those who received high doses. In the moderate group, the percentage of lymphocytes in the low-dose corticosteroid group was considerably higher compared to the high-dose corticosteroid group at the time of discharge.

According to the results, in the case of patients with moderate clinical severity, a low dose of corticosteroids improved the disease, but in the case of patients with severe clinical severity, the results were contradictory, which may be caused by interference of other factors such as underlying diseases, the severity of the illness, etc. in the severe group.