21 July 2020>: Articles
High-Dose Prednisone for Treatment of Autoimmune Pancreatitis in a Patient with Coronavirus Disease 2019 (COVID-19) due to Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Unusual clinical course, Unusual setting of medical care
Hammad Liaquat A* , Brittney Shupp B , Sarina Kapoor C , Ayaz Matin ADOI: 10.12659/AJCR.926475
Am J Case Rep 2020; 21:e926475
Table 1. Studies demonstrating outcomes of corticosteroid use in patients with severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV).
Outbreak | Participants | Methods | Outcomes related to steroid use | Ref |
---|---|---|---|---|
SARS-CoV | 117 previously healthy patients with confirmed diagnosis of SARS-CoV | Compared weekly qualitative CoV RT-PCR assays, chest XR, SARS-COV serology, and daily plasma SARS-CoV RNA concentrations between those who received hydrocortisone 100 mg q 8 hrs placebo group | Early hydrocortisone initiation led to delayed viral clearance | []12 |
Compared 15 patients diagnosed with SARS related psychosis to 30 age and sex matched SARS control subjects with no diagnosis of psychosis | Reviewed the clinical data of SARS patients requiring psychiatric consultation and compared them with the charts of the control group to investigate risk factors | Higher rates of psychosis associated with higher cumulative corticosteroid doses | []14 | |
133 confirmed SARS patients, including 95 who were prescribed glucocorticoids | Reviewed the clinical data of SARS patients to determine fasting plasma glucose (FPG) levels and associated risk factors | Elevated FPG and diagnosis of steroid-induced diabetes were associated with increased doses and duration of corticosteroids | []15 | |
40 hospitalized patients with confirmed SARS infection | 3 months following discharge, SARS patients on corticosteroids were evaluated by MRI to detect avascular necrosis of the femoral head and with ultrasound of the left heel to determine osteoporosis | Increased cumulative dosing of corticosteroids led to higher incidence rates of osteoporosis and avascular necrosis | []16 | |
MERS-CoV | 309 patients who met the MERS eligibility criteria, excluding patients with a history of chronic corticosteroid use | Analyzed the recorded data from a retrospective cohort hospital study involving 14 tertiary care hospitals in Saudi Arabia and compared corticosteroid use and viral RNA clearance in groups that were and were not treated with corticosteroids group | Corticosteroid use had no effect on 90-day mortality but was associated with delayed MERS-CoV RNA clearance | []13 |