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- Title
Early Use of Corticosteroid May Prolong SARS-CoV-2 Shedding in Non-Intensive Care Unit Patients with COVID-19 Pneumonia: A Multicenter, Single-Blind, Randomized Control Trial.
- Authors
Tang, Xiao; Feng, Ying-Mei; Ni, Ji-Xiang; Zhang, Jia-Ying; Liu, Li-Min; Hu, Ke; Wu, Xiu-Zhi; Zhang, Ji-Xian; Chen, Jun-Wen; Zhang, Jian-Chu; Su, Jian; Li, Yu-Lei; Zhao, Yang; Xie, Jiao; Ding, Zhou; He, Xin-Liang; Wang, Wen; Jin, Rong-Hua; Shi, Huan-Zhong; Sun, Bing
- Abstract
Background: There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia. Objective: To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia. Methods: This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization. Results: We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, p = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6–16 days), which was significantly longer than that in the control group (8 days [2–12 days], p = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3+ T cells, CD8+ T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (p < 0.05). Conclusions: From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia. Trial Registration: ClinicalTrials.gov, NCT04273321.
- Subjects
PNEUMONIA; RESEARCH; COVID-19; ADRENOCORTICAL hormones; MEDICAL cooperation; RANDOMIZED controlled trials; BLIND experiment; STATISTICAL sampling; EARLY medical intervention
- Publication
Respiration, 2021, Vol 100, Issue 2, p116
- ISSN
0025-7931
- Publication type
Article
- DOI
10.1159/000512063