Clinical Efficacy of Corticosteroids in the Early Stages of Deterioration in COVID-19 Pneumonia

Zheng Liu,1,* Fang Shi,1 Jun-Xia Liu,1 Jia-Qi Liu,2 Jing Li,1 Qian Wang,1 Hui Wang,1 Chang-Lan Gao,3 Jian-Min Li,1 Dong-Fang Zhao1,* 1Department of Respiratory Medicine, The Petroleum Clinical Medical College of Hebei Medical University, Langfang, Hebei, 065000, People’s Republic of China; 2Schulich School of Medical and Dentistry-Honour Specialization in Interdisciplinary Medical Science and Major in Pharmacology, Western University, London, Ontario, Canada; 3Department of Critical Care Medicine, Langfang Fourth Hospital, Langfang, Hebei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zheng Liu; Dong-Fang ZhaoDepartment of Respiratory Medicine, The Petroleum Clinical Medical College of Hebei Medical University, Langfang, Hebei, 065000, People’s Republic of ChinaTel +86 316 2077814; +86 316 2077345Email zhengl06drsun@163.com; dongfang06_walker@21cn.comBackground: The World Health Organization (WHO) strongly suggests using corticosteroids in patients with severe coronavirus disease 2019 (COVID-19). Similarly, a large randomized controlled clinical trial (RCT) in the UK found that dexamethasone effectively reduced the mortality rate in severe COVID-19 patients. However, the safety profile of corticosteroids has been a controversial area of study.Case Description: A case of a COVID-19 patient is described and the clinical characteristics are observed as the mildly symptomatic patient progresses into a critically ill patient and during their dramatic improvement with corticosteroid therapy in the early stage of the deterioration process with COVID-19 pneumonia.Conclusion: The most suitable timing and dosage for the use of corticosteroids to maximize its effect during the worsening of COVID-19 pneumonia are discussed. One of the main pathophysiological hypotheses for severe COVID-19 patients is related to cytokine storm and virus load, which can be effectively treated with corticosteroid therapy.Keywords: COVID-19 pneumonia, cytokine storm, corticosteroids, clinical characteristic