Therapeutic response to corticosteroids in a critically ill patient with COVID-19: A case report

Medicine (Baltimore). 2020 Jul 31;99(31):e21597. doi: 10.1097/MD.0000000000021597.

Abstract

Introduction: Since the coronavirus disease 2019 (COVID-19) outbreak in Wuhan in late 2019, controversy on the use of corticosteroids for COVID-19 has obtained increasing attention. We present 1 critically ill patient who had a rapid therapeutic response to moderate-dose corticosteroids.

Patient concerns: A 53-year-old critically ill woman from Wuhan suffered with COVID-19.

Diagnosis: The chest computed tomography scan was suggestive of COVID-19. The diagnosis was confirmed by a real-time reverse transcription polymerase chain reaction test for SARS-CoV-2. The critically ill status was characterized by worsening dyspnea, progressing bilateral lung consolidation, and poor oxygenation (SiO2/FiO2:110 mm Hg).

Interventions: The patient was treated with a moderate dose of intravenous corticosteroids and high-flow nasal cannula oxygen therapy.

Outcomes: After the initiation of corticosteroids, the patient rapidly improved over the following 6 days. Serial chest computed tomography scans showed good absorption of the consolidations. The patient was discharged on Day 17 of hospitalization without obvious adverse effects.

Conclusions: Early use of moderate-dose corticosteroids over a short period may enhance recovery from COVID-19 in critically ill patients.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Combined Modality Therapy
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Middle Aged
  • Oxygen Inhalation Therapy / methods*
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones