Risk-adapted Treatment Strategy For COVID-19 Patients

• Main Authors: Changcheng Zheng, Jinquan Wang, Hui Guo, Zhaohui Lu, Yan Ma, Yuyou Zhu, Daqing Xia, Yinzhong Wang, Hongliang He, Jian Zhou, Yong Wang, Mingming Fei, Yihong Yin, Mao Zheng, Yehong Xu
• Format: Article
• Language: English
• Published: Elsevier 2020-05-01
• Series: International Journal of Infectious Diseases
• Subjects: COVID-19; novel coronavirus pneumonia; risk-adapted treatment strategy; antiviral treatment; low-dose corticosteroid
• Online Access: http://www.sciencedirect.com/science/article/pii/S120197122030179X

Background: There are no clear expert consensus or guidelines on how to treat 2019 coronavirus disease (COVID-19). The objective of this study is to investigate the short-term effect of risk-adapted treatment strategy on patients with COVID-19. Methods: We collected the medical records of 55 COVID-19 patients for analysis. We divided these patients into mild, moderate and severe groups, and risk-adapted treatment approaches were given according to the illness severity. Results: Twelve patients were in mild group and 22 were in moderate group (non-severe group, n = 34), and 21 patients were in severe group. At the end of the first two weeks after admission, clinical manifestations had completely despeared in 31(91.2%)patients in non-severe group, and 18(85.7%) patients in severe group (p = 0.85). Both groups had a satisfied chest CT imaging recovery, which includes 22(64.7%) patients in non-severe group and 12(57.1%) patients in severe group recovered at least 50% of the whole leisions in the first week, and 28(82.4%) and 16(76.2%) recovered at least 75% in the second week, respectively. There were no significant differences in SARS-CoV-2 nucleic acid negativity (p = 0.92). There were also no significant differences in the levels of SARS-CoV-2-IgM and IgG antibody production between the two groups (p = 0.13, 0.62). There were 45 cases were discharged from the hospital, and no patients died at the time of this clinical analysis. Conclusions: Risk-adapted treatment strategy was associated with significant clinical manifestations alleviation and clinical imaging recovery. In severe COVID-19 patients, early and short-term use of low-dose methylprednisolone was beneficial and did not delay SARS-CoV-2 nucleic acid clearance and influence IgG antibody production.