Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report

• Main Authors: Zhang Jian, Tian Zigang, Feng Lina, Yang Zhongming, Zou Bo, Li Kun, Zhang Yingliang, Wang Yaguo, Fleming Joy, Cui Wenyu
• Format: Article
• Language: English
• Published: De Gruyter 2021-03-01
• Series: Open Medicine
• Subjects: sars-cov-2; cytokine storm; acute respiratory distress syndrome; methylprednisolone; personalized medicine
• Online Access: https://doi.org/10.1515/med-2021-0250

Inflammation-mediated lung injury in severe cases of infection with SARS-CoV-2, the aetiological agent of Coronavirus disease 2019 (COVID-19), can lead to respiratory failure and death, and therapies that block or ameliorate lung injury-associated inflammatory “cytokine storms” and progression to acute respiratory distress syndrome (ARDS) are urgently needed. Therapeutic use of corticosteroids for this purpose has been controversial because of conflicting reports on their efficacy and immunosuppressive behaviour. The WHO has strongly recommended treating critical COVID-19 patients with systemic corticosteroid therapy, but recommends against corticosteroid therapy in non-severe COVID-19 disease because of a lack of strong evidence on its efficacy. This retrospective case report describing the successful treatment of a non-severe COVID-19 case in Changchun, China, by judicious administration of corticosteroids using a personalized therapeutic approach was recorded to strengthen the evidence base showing how corticosteroid use in non-severe COVID-19 cases can be safe and efficacious. Alongside supportive care and lopinavir/ritonavir antiviral drugs, a low dosage of methylprednisolone was administered over a short period to attenuate lung inflammation. Regular chest CT scans guided dosage reduction in response to lesion absorption and improved lung condition. Judicious use of corticosteroids safely attenuated disease progression and facilitated rapid and complete recovery.