Effect of dexamethasone in two different doses on specific biochemical markers in patients with COVID-19

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 is the causative agent of coronavirus disease 2019 (COVID-19). The release of alarmins results in a “cytokine storm,” which can be attenuated by the immunomodulatory and anti-inflammatory effects of dexamethasone. Aim: To evaluate and assess the effect of dexamethasone in two different doses, on D-dimer, serum ferritin, C-reactive protein (CRP) levels, and granulocyte/lymphocyte (%) in patients with COVID-19. Patients and methods: A total of 100 patients were randomly divided into two groups; group A patients received a higher dose of dexamethasone than those in group B. Measurements of certain hematological and biochemical markers, including D-dimer, serum ferritin, CRP, and granulocyte/lymphocyte ratio were done for all the patients in both groups. These indices were compared at different times of treatment between the two groups. Results: The D-dimer and granulocyte/lymphocyte ratio measurements were statistically non-significant in both the groups in all three readings. The serum ferritin measurement was significant only on the 6th day of treatment. The results demonstrated that group A patients had significantly lower CRP levels on both the 3rd and 6th days of treatment. Conclusion: Administration of a slightly higher dose of dexamethasone (8 mg per day for three days, then 6 mg per day for another 3 days) in patients hospitalized with COVID-19 effectively reduces the inflammatory and hematological biomarkers in patients who required supplemental oxygen therapy.