Timing of of corticosteroids administration is very important in COVID19 cases for the recovery and decrease the mortality.
The sickest patients with COVID-19 suffer a hyperinflammatory state-a cytokine storm-that has features in common with a rare haematological condition called haemophagocytic lymphohistiocytosis. Immune suppression should help such patients. By contrast, immune suppression during the early phase of the viral infection might allow increased viral replication and aggravate the disease. The 3C-like proteinase on SARS-CoV-2 (nsp5) inhibits HDAC2 transport into the nucleus, and so impairs the way in which it mediates inflammation and cytokine responses, so activation of histone deacetylase by dexamethasone may directly oppose the action of SARS-CoV-2. Timing of of corticosteroids administration is very important in COVID19 cases for the recovery and decrease the mortality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
752
early use of dexamethasone/Methylprednisolone as early as laboratory evidence of high inflammatory markers
Asalam
Maadi, Cairo Governorate, Egypt
Percentage of cases that will need hospitalization
Deterioration in the clinical picture of cases that necessitate hospitalization
Time frame: 10 days
Percentage of cases that will need oxygen supplementation
Percentage of cases whose clinical status deteriorate that their sPO2 become less than 92%
Time frame: 10 days
28-days mortality
Percentage of cases who died within 28 days of presentation
Time frame: 28 days
Percentages of COVID-19 Severity according to CDC 2020
Percentages of COVID-19 severity according to CDC 2020
Time frame: 10 days
Time to return to daily activity
Time to return to daily activity level
Time frame: 60 days
Percentage of cases with increased d-dimer
Percentage of cases with increased d-dimer from baseline
Time frame: 10 days
Percentage reduction in CRP
Percentage reduction in CRP from baseline
Time frame: 10 days
Percentage reduction in LDH
Percentage reduction in LDH from baseline
Time frame: 10 days
Percentage reduction in Ferritin
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Percentage reduction in Ferritin from baseline
Time frame: 10 days