Effect of prednisolone on inflammatory biomarkers in interstitial pneumonia associated with coronavirus infection
Glucocorticoids are often prescribed for inflammatory conditions and have recently become very commonly used in the treatment of pneumonia associated with COVID-19. Some studies have shown an effect of glucocorticoids on levels of inflammatory markers, but there is no definitive evidence. We have studied in our research the effect of prednisolone on inflammatory biomarkers in a placebo-controlled trial of two groups of patients hospitalized with a diagnosis of COVID-19 coronavirus infection, virus identified (polymerase chain reaction – positive), moderate course with bilateral interstitial pneumonia, lung tissue damage up to 30–50 %, respiratory failure 1–2 degree. Prednisolone at a dose of 180 mg/day was parenterally prescribed one of the groups; the other group received a placebo. We compared the levels of C-reactive protein (CRP), procalcitonin (PCT), leukocyte and neutrophil counts in these two groups at baseline, days 3, 5, 7 and at discharge using Wilcoxon tests and analysis of variance. 356 patients in the prednisolone group and 355 patients in the placebo group were included in the analysis totally. Prednisone showed a reduction in CRP on days 3, 5, and 7 (mean difference 46 %, P<0.001 for each time point) in comparison with placebo. Such difference was not observed in case of PTC. The number of leukocytes and neutrophils was higher in the prednisolone group at all time points (mean difference 27 % for leukocytes and 33 % for neutrophils,
P < 0.001 for all time points). We concluded that patients with COVID-19-associated interstitial pneumonia had lower CRP levels and increased white blood cell as well as neutrophil counts after glucocorticoid administration compared to the placebo group. PCT levels did not differ between the two groups. The level of procalcitonin has been found to be somewhat affected by the severity of the disease itself, but it is not a reliable marker in patients with COVID-19 receiving hormone therapy.
Ruta A.V., Luchinina E.V., Shelekchova T.V., Zaitseva M.R., Luchinin E.A., Bontsevich R.A. 2022. Effect of prednisolone on inflammatory biomarkers in interstitial pneumonia associated with coronavirus infection. Challenges in Modern Medicine. 45 (2): 129–140 (in Russian). DOI: 10.52575/2687-0940-2022-45-2-129-140
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