EFFECT OF PULSE STEROID THERAPY ON MORTALITY IN SEVERE COVID-19 PNEUMONIA

Yıl 2021, Cilt: 28 Sayı: 3, 479 - 486, 13.09.2021

Ahmet BİNDAL

https://doi.org/10.17343/sdutfd.982218

Öz

Objective
We aimed to observe the effect of pulse steroid
therapy used in the hyperinflammatory phase that
occurs during the course of the COVID-19 disease
on the inflammatory markers and clinical conditions
of the patients.
Materials and Methods
In this study, 30 patients with positive COVID-19 PCR
(polymerase chain reaction) test who were treated
with pulse steroid (high-dose methylprednisolone)
due to the hyperinflammatory phase were evaluated.
The clinical conditions and inflammatory markers
of the patients were retrospectively analyzed.
Patients were evaluated in terms of age, gender,
intubation status, clinical improvement, discharge,
mortality rate, 24th, 48th, 72nd hours and 7th days
after treatment initiation, C-reactive protein (CRP),
procalcitonin, ferritin, oxygen saturation values,
lymphocyte count.
Results
A total of 30 patients; 21 male and 9 female, who
received pulse steroid therapy were examined. The
median age was calculated as 66 [31-88]. In the
study, 15 (50%) patients died, of which 11 were male
and 4 were female. When the survived and deceased
patients were compared, it was observed that the
values of ferritin, CRP procalcitonin measured at
72 hours and 7 days after pulse steroid treatment
decreased significantly in the survived patient group.
(72nd hour p-values=0.01-0.08- <0.05, respectively)
(7th day p-value=0.01-0.07-<0.05, respectively)
Conclusion
The significant decrease in inflammatory markers
such as ferritin and CRP after pulse steroid therapy
and the fact that this decrease is more obvious in the
survived patient group suggests that steroids can be
used in hyperinflammatory processes.

Anahtar Kelimeler

COVID-19, pulse steroid therapy, CRP, ferritin

AĞIR COVID-19 PNÖMONİSİNDE PULSE STEROİD TEDAVİSİNİN MORTALİTE ÜZERİNE ETKİSİ

Öz

COVID-19 hastalığının süreci esnasında ortaya çıkan
hiperinflamatuar fazda kullanılan pulse steroid tedavisinin
hastaların inflamatuar belirteçlerine ve klinik
durumlarına etkisini gözlemlemeyi amaçladık.
Gereç ve Yöntem
Bu çalışmada hiperinflamatuar faz nedeniyle pulse
steroid (yüksek doz metilprednizolon) ile tedavi edilen,
COVID-19 PCR (polimeraz zincir reaksiyonu)
testi pozitif olan 30 hasta değerlendirildi. Hastaların
klinik durumları ve inflamatuar belirteçleri retrospektif
olarak incelendi. Hastalar; yaş, cinsiyet, entübasyon
durumu, klinik düzelme, taburculuk, mortalite oranı,
tedavi başlangıcından 24-48-72. saat ve 7. günde ölçülen;
C-reaktif protein (CRP), prokalsitonin, ferritin,
oksijen saturasyon değeri ve lenfosit sayısı açısından
değerlendirildi.
Bulgular
Toplamda pulse steroid tedavisi alan 21 erkek, 9 kadın
olmak üzere 30 hasta incelendi. Ortanca yaş 66
[31-88] olarak hesaplandı. Çalışmada 15 (%50) hasta
vefat etmiş olup, bunun 11’i erkek, 4’ü kadın hastaydı.
Yaşayan ve ölen hastalar karşılaştırıldıklarında; pulse
steroid tedavisi sonrası 72. saat ve 7. günde ölçülen
ferritin, CRP, prokalsitonin değerlerinin yaşayan hasta
grubunda anlamlı olarak azaldığı görüldü. (sırasıyla
72. saat p= 0,01; 0,08 ; <0,05) (sırasıyla 7. gün p =
0,01; 0,07 ; <0,05)
Sonuç
Pulse steroid tedavisi sonrası ferritin, CRP gibi inflamatuar
belirteçlerin anlamlı olarak azalması ve bu
azalmanın yaşayan hasta grubunda daha belirgin olması,
steroidlerin hiperinflamatuar süreçlerde kullanılabileceğini
düşündürmektedir.

Anahtar Kelimeler

COVİD-19, pulse steroid tedavisi, CRP, ferritin

Kaynakça

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