As of April 4, 2020, a total of 1,051,635 coronavirus disease 2019 (COVID-19) cases had been reported worldwide, among which 56,985 deaths occurred (5.42%).1 However, to date, no vaccine and no specific antiviral medicine are available to prevent or treat COVID-19. A previous study suggested that cytokine release syndrome could be involved in the pathophysiology of severe or critical COVID-19 cases and frequently results in death.2 Hence, early recognition and effective suppression of the cytokine storm may be life-saving in severe or critical patients. The Fifth Affiliated Hospital of Sun Yat-sen University was the first and, at the time of this report, remains the only designated hospital for management of COVID-19 patients in Zhuhai, China. From January 22 to March 2, we treated 101 patients with COVID-19 in total. Although the previously reported fatality rate for severe and critical patients with COVID-19 was considerable,2 those whom we treated all survived. Despite controversies, we think that timely and appropriate application of glucocorticoid plays a crucial role in the treatment of these patients. Herein, we introduce our clinical experience with corticosteroid administration in these patients for reference and discussion.
During the study period, the Fifth Affiliated Hospital of Sun Yat-sen University was the only designated hospital for the treatment of COVID-19 in Zhuhai, China, and all suspected or confirmed cases in this city were compulsarily admitted to it. All the hospitalized patients were managed by an expert panel consisting of experienced clinicians from pulmonology, critical medicine, infectious diseases, radiology, microbiology, and pathology departments.
Diagnosis of COVID-19 was made on the basis of criteria of the “Diagnosis and Treatment of New Coronavirus-Infected Pneumonia” (Sixth trial version) draft by the National Health Commission of China. Specific IgG antibody had to be tested with the ELISA method before discharge of patients. Furthermore, patients have been followed up and their lung function measured within 1 month of discharge.
This case series was approved by the Institutional Ethics Board of the Fifth Affiliated Hospital of Sun Yat-sen University. Consecutive patients with confirmed COVID-19 admitted from January 22 to March 2, 2020, were enrolled. Oral consent was obtained from patients. We collected and analyzed the clinical data of these patients.