key: cord-289169-3u7qgxud
authors: Fang, Xiaowei; Mei, Qing; Yang, Tianjun; Li, Lei; Wang, Yinzhong; Tong, Fei; Geng, Shike; Pan, Aijun
title: Low-dose corticosteroid therapy does not delay viral clearance in patients with COVID-1
date: 2020-04-11
journal: J Infect
DOI: 10.1016/j.jinf.2020.03.039
sha: 
doc_id: 289169
cord_uid: 3u7qgxud

nan

drugs and symptomatic therapies. Furthermore, patients in the severe group received the necessary supportive treatment. Corticosteroids were administrated to a subset of patients according to severity and the individual opinion of clinicians. More severe patients were treated with corticosteroids, leading to inconsistent baseline data (i.e., age, comorbidities and laboratory findings) between patients receiving corticosteroids and those who did not. Therefore, the 78 patients were divided into a general and a severe group, and separate data analysis was conducted for each group. Table 1 Therefore, these two studies involved patients with different severities of illness;

however, whether corticosteroids exerted greater effects in critically-ill patients requires further investigation. Furthermore, the study reporting on patients with MERS included RT-PCR data from 14 intensive care units, and the nucleic acid test results were not protocolized and varied among centers (5) . In the present study, all patients were from a single center, and all swab samples were tested using a unified approach at the Chinese Center for Disease Control to avoid measurement bias.

In fact, a similar study analyzing data from 72 patients with COVID-19 was conducted at the First Affiliated Hospital of Zhejiang University, and the conclusions were consistent with the results of the present study (7) . However, these two retrospective studies have unavoidable limitations, such as small sample size, poor controllability of the data and bias in the process of data collection. In conclusion, low-dose corticosteroid therapy may not delay viral clearance in patients with COVID-19; however, this still needs to be confirmed by well-designed and large-scale

RCTs with a longer follow-up duration.

Ethics approval was obtained from Anhui Provincial Hospital Institutional

Review Board (ethical approval no. 2020-P-008).

The authors declare that they have no competing interests.

All the authors agree to publish. 

Clinical progression of patients with COVID-19 in Shanghai

Clinical features of patients infected with 2019 novel coronavirus in Wuhan

National Health Commission of the People's Republic of China. The 5th trial version of Diagnosis and Treatment Scheme for Pneumonitis with 2019-nCoV Infection (In Chinese)

Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients

Corticosteroid Therapy for Critically Ill Patients with the Middle East Respiratory Syndrome

Adjuvant Corticosteroid Treatment in Adults With Influenza A (H7N9) Viral Pneumonia

Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia

Creatinine (µmol/L), median (Q1, Q3)

We thank all medical staff working in the Infectious Diseases Branch of Anhui Provincial Hospital for their essential assistance with case collection. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
