SYSTEMIC STEROIDS IN COVID-19 PNEUMONIA: A RETROSPECTIVE ANALYSIS

Abstract

TYPE: Abstract TOPIC: Critical Care PURPOSE: The objective of study is to assess correlation of P:F ratio in SARS-CoV-2 patients receiving systemic steroids. METHODS: We conducted retrospective analysis in local hospital in California. Patient population included 250 patients who were adults above 18 years old who tested positive via nasopharyngeal RT-PCR assays between 03,2020 to 06,2020. P:F ratio of patients were measured on days 1-7 and day 14 following steroid injection. Patient mortality is indicated by lower PaO2 to FiO2 ratio over time, on average. The time series plots of all patients are averaged over time using local polynomial regression of the ratio in the log scale. RESULTS: Our study showed patients who received first dose of steroid injection with lower initial P:F ratio had worse outcomes compared to patients with higher P:F ratio. 23.6% of patients (59/250) died despite receiving intravenous steroids. Our study showed patients with P:F ratio lower than 230 on average had worse outcomes. Limitations for this study included smaller sample size and skewness in distribution. Because of skewness in distribution, time series plots of all patients are averaged using local polynomial regression. CONCLUSIONS: P:F ratio correlates clinically with severity of respiratory failure and prognosis. Systemic steroids may result in slowing the disease progression and halt the inflammatory cytokine storm. Steroids administered during early hospitalization resulted in improved outcomes in our patient population. CLINICAL IMPLICATIONS: We recommend initiating systemic steroids in patients earlier in their clinical course despite a high P:F ratio as it may improve clinical outcomes and disease progression. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19