The Effect of Dexamethasone on Outcome of Patients with Severe COVID-19. A Retrospective Cross Sectional Study

Author(s): Carlos Andres Munoz Tello, Alyanna Marie B Manego, Carol Mfoniso Etudor, Joseph A Manuel, Fizza Mohsin, Levis Abin Joy, Purnadeo Persaud, Muhammad Umar Farooq Azam, Sidra Naz, Muhammad Ijaz Khan, M

Introduction: Severe manifestation of Coronavirus disease 2019 (COVID-19) appears to be linked to massive inflammatory response. Glucocorticoids may help to prevent respiratory failure and death by modulating inflammation-mediated lung damage. Nonetheless, there is little conclusive evidence that it is effective in COVID-19 patients.The current study was proposed to see the differences in several outcomes between the severe COVID-19 patients who received usual care plus dexamethasone (the dexamethasone group), The current study was proposed to see the differences in several outcomes between the severe COVID-19 patients who received usual care plus dexamethasone (the dexamethasone group), and those who did not receive dexamethasone (the usual care group).

Methods: This retrospective study was conducted at Hayatabad Medical Complex Peshawar Pakistan (Isolation units for COVID-19). Patients with severe COVID-19 admitted to hospital from March to July 2020 were included in the study. Data was collected using structured format. Mean differences were calculated using independent sample t test whereas Chi square test was used for determination of association.

Results: A total of 193 patients were included in the final analysis. No significant difference in age, gender, respiratory rate, C-reactive protein, and lactate dehydrogenase between the groups was observed. Patients who received usual care plus dexamethasone were discharged earlier from hospital (8.20 ± 1.90 vs. 11.20 ± 2.40, p< 0.001), and had low percentage of mechanical ventilation (MV) requirement (15.10% vs. 28.30%, p = 0.02). Overall mortality was low in dexamethasone group, however no difference in mortality rate between both the two groups was noted (9.80% vs. 19.70%, p = 0.058). Furthermore, in comparison to the usual care group, mortality rate in patients on MV was lower in dexamethasone group (56.50% vs.23.50%, p =