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首页> 外文期刊>Journal of Clinical and Diagnostic Research >A Retrospective Evaluation of Combination Therapy of Methylprednisolone and Remdesivir for Severe COVID-19 Patient
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A Retrospective Evaluation of Combination Therapy of Methylprednisolone and Remdesivir for Severe COVID-19 Patient

机译：甲基丙酮酮组合治疗及严重Covid-19患者雷德肽的回顾性评价

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Severe and threatening complications of Corona Virus Disease-2019 (COVID-19) are caused by direct viral injury as well as excessive and aberrant host immune response induced by the virus. In this context, use of Methylprednisolone (MP) to prevent cytokine storm and Remdesivir to prevent viral replication seems prudent.Aim: To assess the clinical outcome of combination therapy of Remdesivir and MP pulse therapy in patients with severe COVID-19 in Intensive Care Unit (ICU).Materials and Methods: The retrospective study was conductedin the COVID-19 ICU, dealing exclusively with 21 severe illness severe illness cases at Safdurjung Hospital, New Delhi, India from June to July 2020. They were given MP pulse therapy (500 mg/day for three days, followed by 1 mg/kg orally once daily, tapered by 10 or 20 mg/day and finishing with 10 mg) along with intravenous Remdesivir. Pre and post-therapy examination of the patients included clinical features, inflammatory markers (Interleukin-6, ferritin and D-dimer), gas parameters like ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2 /FiO2 ) and changes in chest radiograph. Values of PaO2 / FiO2 , inflammatory markers on day 1 and day 3 were expressed as mean?±SD and their difference compared using student t-test. Statistical significance was defined as p<0.05.Results: This treatment regimen was associated with significant improvement in PaO2 /FiO2 (p<0.001), significant decrease in inflammatory markers (p<0.001) and reversal of radiological changes. Ten patients were discharged within two weeks of treatment while six patients were shifted to high dependency unit for further oxygen requirement. They were all successfully discharged from hospital without oxygen requirement within next two weeks. Five patients developed opportunistic infections and succumbed to death. Side-effects of therapy included hyperglycaemia in nine patients, which was managed by insulin infusion.Conclusion: Combination therapy of MP pulse and Remdesivir in patients with severe COVID-19 resulted in significant clinical improvement. Given the high efficacy, it could be one of the promising approaches to the management of patients with severe COVID-19.
机译：Corona病毒病 - 2019（Covid-19）的严重和威胁性并发症是由直接病毒损伤以及病毒诱导的过度和异常的宿主免疫应答引起的。在这种情况下，使用甲基丙酮（MP）以防止细胞因子风暴和雷级肽以防止病毒复制似乎是谨慎的.aum：评估重症监护单元严重Covid-19患者的雷达维尔和MP脉冲治疗的联合治疗的临床结果（ICU）。材料和方法：回顾性研究是在Covid-19 ICU进行的，其在6月到2020年6月，印度新德里苏丹医院的21例严重疾病案例。给予MP脉冲治疗（500毫克/天三天，其次每天一次1mg / kg，逐渐逐渐变吐10或20mg /天，并用10mg完成10mg）以及静脉内雷德肽。治疗前后治疗患者包括临床特征，炎症标记物（白细胞介素-6，铁蛋白和D-二聚体），气体参数等动脉氧分压比与分数启发的氧气（PAO2 / FIO2）和胸部射线照片的变化。第1天和第3天的PaO2 / FiO2，炎症标记的值表示为使用学生T检验比较的平均值α±SD及其差异。统计学意义定义为P <0.05.结果：该治疗方案与PAO2 / FIO2（P <0.001）的显着改善有关，炎症标志物显着降低（P <0.001）和放射性变化的逆转。 10名患者在治疗后的两周内排出，而六名患者被转移到高依赖性单元以进行进一步的氧气要求。他们都在未来两周内从医院开始从医院出发。五名患者开发了机会主义感染，并屈服于死亡。治疗的副作用包括九个患者的高血糖血症，其由胰岛素输液管理。结论：严重Covid-19患者MP脉冲和雷德肽的联合治疗导致显着的临床改善。鉴于高效率，可能是对严重Covid-19患者管理的有希望的方法之一。

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