ÀÌÇö¿ì(Lee Hyun-Woo) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Internal Medicine
¹ÚÁö¸í(Park Ji-Myung) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Internal Medicine
ÀÌÁ¤±Ô(Lee Jung-Kyu) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Internal Medicine
¹ÚÅ¿¬(Park Tae-Yeon) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Internal Medicine
ÇãÀº¿µ(Heo Eun-Young) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Internal Medicine
Abstract
Background: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration.
Methods: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO2 <90%.
Results: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups.
Conclusion: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality.
Å°¿öµå
Coronavirus Disease 2019 (COVID-19), Pneumonia, Inhalation Therapy, Oxygen, Dexamethasone, Respiratory Failure
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). The administration of dexamethasone within 24 hours of oxygen supplementation correlated with a lower rate of HFNC or MV treatment in patients with severe COVID-19 pneumonia.