Abstract
Objectives To evaluate the role of short-term low-dose glucocorticoids in mild COVID-19 patients. Methods We conducted a retrospective, cross-sectional, single-center study in Kunming, China. A total of 33 mild COVID-19 cases were divided into two treatment groups (with and without glucocorticoids, methylprednisolone, were used in this setting), and the absolute value of peripheral blood lymphocyte count; CD3+, CD4+, and CD8+ T cell counts; and the time to achieve negative transformation of a nucleic acid pharyngeal swab were recorded. Peripheral blood lymphocyte and T cell counts were compared between the treatment group and 25 healthy individuals. At the point of time when there was a 50% accumulation conversion rate (positive to negative nucleic acid on pharyngeal swab), and the nucleic acid turned negative in half of the patients in two groups, the peripheral blood lymphocyte and T cell counts were compared between treatment groups. Results The mean cumulative time for the 50% negative conversion rate of the nucleic acid in the pharyngeal swab was 17.7 ± 5.1 days and 13.9 ± 5.4 days in the glucocorticoid group and the nonglucocorticoid group, respectively. The absolute peripheral blood lymphocyte count and the T cell subset count in the glucocorticoid group were lower than those in the nonglucocorticoid group. When the nucleic acid turned negative in half of the patients, the absolute value of peripheral blood lymphocyte count and CD4+ T cells of the glucocorticoid group and the nonglucocorticoid group was not significantly different; the CD3+ and CD8+ T cells in the glucocorticoid group were lower than those in the nonglucocorticoid group. The absolute peripheral blood lymphocyte count, CD3+ T cells, and CD4+ T cells in the glucocorticoid group were lower than those of the healthy group during the whole disease period, and CD8+ T cells returned to normal at 19-21 days of the disease period. There was no significant difference between the nonglucocorticoid group and the healthy group for absolute peripheral blood lymphocyte and CD8+ T cells; moreover, CD3+ T cells and CD4+ T cells were lower in the nonglucocorticoid group than those in the healthy group from the day of admission to the 18th day and returned to normal at the period of 19-21 days. The absolute peripheral lymphocyte count (P = 0.048, effect size d = 0.727) and T cell subset count (CD3: P = 0.042, effect size d = 0.655; CD4: P < 0.01, effect size d = 0.599; and CD8: P = 0.034, effect size d = 0.550) in the nonglucocorticoid group were higher than those in the glucocorticoid group, and the difference between the groups was statistically significant. Conclusions This study found that the use of short-term, low-dose glucocorticoids does not negatively influence the clinical outcome, without affecting the final clearance of viral nucleic acid in mild COVID-19 patients.
Highlights
The coronavirus disease 2019 (COVID-19) has already become a global epidemic, and most infected patients have presented with mild symptoms
The diagnosis criteria for COVID-19 were based on the “Diagnosis and treatment scheme of pneumonia infected by novel coronavirus” issued by the National Health Commission and listed as follows [8]: (1) Epidemiology: travel or residence history in or around Wuhan, China, or other communities with reported cases within 14 days prior to symptom onset; a history of exposure to novel coronavirus infection within 14 days prior to symptom onset; exposure to someone with fever or respiratory symptoms from Wuhan City and surrounding areas, or from communities where cases were reported in the 14 days prior to the onset of illness; and exposure to a highly dense area of COVID-19 infections prior to the onset of illness
When the nucleic acid turned negative in half of the patients, the absolute value of peripheral blood lymphocyte count (Figure 1(e)) and CD4+ T cells (Figure 1(f)) of the glucocorticoid group and the nonglucocorticoid group were not significantly different; the CD3+ and CD8+ T cells in the glucocorticoid group were lower than those in the nonglucocorticoid group; the P value was less than 0.05 (Figure 1(f)) (Supplementary Table 2)
Summary
The coronavirus disease 2019 (COVID-19) has already become a global epidemic, and most infected patients have presented with mild symptoms. Many patients presented with mild symptoms which rapidly progressed to severe condition and were associated with an increased risk of mortality [1]. It has remained unclear how BioMed Research International to control the inflammatory response to prevent the aggravation of the disease in mild patients. A comprehensive investigation into the dynamic changes of immune function, the association between immune function and viral nucleic acid clearance, and effect of glucocorticoids on immune function is crucial for the treatment of mild COVID-19. This study is aimed at describing the changes in immune function and assessing the effect of short-term low-dose glucocorticoids on immune function and viral nucleic acid clearance for patients with mild COVID-19
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
