Abstract
BackgroundPneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause severe inflammation of the lungs resulting in acute respiratory distress syndrome (ARDS). Current treatment guidelines support use of remdesivir as well as dexamethasone in hypoxic patients. There is very little information known about use of inhaled corticosteroids (ICS) in combination with the other two medications. Methods and outcomesWe report our experience among six coronavirus disease 2019 (COVID-19) patients who received ICS, remdesivir and dexamethasone for treatment as well as their outcomes. Data were obtained from retrospective chart review during a two-week period from July 8, 2020 to July 22, 2020. Five patients were treated successfully and discharged home. One patient expired.ConclusionsThis case series highlights the possible benefits of inhaled steroids in treatment of COVID-19 patients with hypoxia. Further randomized controlled studies are needed to assess inhaled corticosteroids as possible treatment either alone or in combination with systemic steroids for treating COVID-19 patients. Dose and optimal duration need to be studied and evaluated.
Highlights
Coronavirus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially reported in China in late 2019 [1]
We report our experience among six coronavirus disease 2019 (COVID-19) patients who received inhaled corticosteroids (ICS), remdesivir and dexamethasone for treatment as well as their outcomes
This case series highlights the possible benefits of inhaled steroids in treatment of COVID-19 patients with hypoxia
Summary
Coronavirus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially reported in China in late 2019 [1]. As of August 7th, 2020 there have been more than 17.5 million cases worldwide and more than 4.5 million cases in the United States [2] It has been a rapidly evolving disease with frequent updates in treatment guidelines based on ongoing research. In a randomized double-blinded control study, Adaptive COVID-19 Treatment Trial (ACTT-1), remdesivir was noted to reduce the recovery period in patients who were admitted to hospital [3]. Based on this data, remdesivir has been included as part of treatment in hypoxic patients admitted to the hospital who met certain institutional criteria. There is very little information known about use of inhaled corticosteroids (ICS) in combination with the other two medications
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