Effectiveness of Dexamethasone as an Adjunct Drug in Treatment of Critical COVID-19 Patients: An Observational Single Cohort

Abstract

Introduction: Corticosteroids have shown controversial results in severe infections. Limited data is available to prove the efficacy of this drug against Coronavirus Disease 2019 (COVID19) infection. Such studies have highlighted that steroids such as dexamethasone can be effective against the patients who are exhibiting severe symptoms of COVID-19. Aim: To determine the effectiveness of dexamethasone as adjunct drug in treatment of in critical COVID-19 patients. Materials and Methods: This observational single cohort study was conducted on all COVID-19 positive patients admitted to the tertiary care hospital, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India during August 2020 to October 2020. Critically ill patients suffering from COVID-19 receiving 6 mg dexamethasone along with standard treatment protocol as prescribed by the Indian Council of Medical Research (ICMR) were included in this study. Serum interleukin-6, D-dimer, ferritin, levels along with CT values from RT-PCR of nasopharyngeal and oropharyngeal swab were recorded on the day of admission and after 7 days of dexamethasone therapy along with standard treatment protocol of ICMR. The data was analysed using descriptive statistics and paired-t test. Results: There were 22 males and 28 females enrolled in the study with mean age of males as 55 years and mean age of females as 56 years. The mean weight of males was 68.4 kg, while the mean weight of females was 59.8 kg. Statistically significant decrease in serum levels of interleukin-6, D-dimer, and ferritin after 7 days of dexamethasone treatment along with standard treatment protocol of ICMR was observed. The results were found to be significantly different with p-values=0.001, 0.003 and 0.002, respectively. Conclusion: Dexamethasone, as an adjunct drug, is an important corticosteroid that is efficient in countering the inflammatory response generated in COVID-19 patients along with standard treatment protocol of ICMR. It reduces the inflammatory markers in patients suffering from COVID-19.