Retrospective Evaluation of COVID-19 Patients Receiving Low-Dose Dexamethasone Therapy in the Intensive Care Unit
Low-Dose Dexamethasone in COVID-19
DOI:
https://doi.org/10.71350/ajaic.4Keywords:
COVID-19, Intensive care, Dexamethasone, InflammationAbstract
Background: COVID-19 is associated with high mortality in critically ill patients due to an exaggerated inflammatory response characterized by a cytokine storm. In this context, the anti-inflammatory properties of corticosteroids have emerged as a significant therapeutic option. This study retrospectively evaluated COVID-19 patients who received low-dose dexamethasone therapy in the intensive care unit, and the relationship between survival status and changes in laboratory parameters was investigated.
Materials and Methods: Between June and August 2020, 80 patients with a confirmed diagnosis of COVID-19 by RT-PCR who received low-dose dexamethasone therapy (6 mg/day, up to 10 days) in the intensive care unit were analyzed. Patients were divided into two groups according to their clinical outcomes: survivors (n=41) and non-survivors (n=39). Laboratory measurements were recorded at two time points: within the first 24 hours of ICU admission (T0) and on day 5 ±2 (T1). Percentage changes were calculated.
Results: The mean age of the survivor group was higher than that of the non-survivor group (77.1 vs. 62.3 years; p<0.001). At T0, WBC levels were lower in the non-survivor group (p=0.027). Regarding the change from T0 to T1 in IL-6 levels, a decrease of 76.6% was observed in the non-survivor group and 54.5% in the survivor group (p=0.045). Ferritin levels increased in the survivor group but decreased in the non-survivor group (p=0.001). D-dimer levels showed a marked increase in the survivor group, whereas a decrease was observed in the non-survivor group (p<0.001).
Conclusion: The literature has strongly demonstrated that corticosteroids can improve survival in patients with severe COVID-19. The unique contribution of this study lies in revealing the changes in laboratory parameters between survival groups under dexamethasone therapy. Although the findings do not establish a direct relationship with mortality, they may serve as hypothesis-generating data that contribute to understanding the heterogeneity of clinical responses.
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