Objectives: Dexamethasone is most wildly used corticosteroid for treatment of COVID 19 - pulmonary complications. This study was designed to evaluate the effects of dexamethasone on so serum level of some of the inflammatory factors, cortisol, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in COVID 19 pneumonia with pre-existing COPD
Material & Methods: A total of 36 critically ill COVID 19 pneumonia patients with the pre-existing COPD and 56 positive COVID-19 patients without a pre-existing COPD were selected. A daily dose of 6- 8 mg of dexamethasone was administered during the hospitalization period. Some of the inflammatory markers (IL-6, IL-10 & TNF-α), as well as the serum level of cortisol, LDH and CRP were measured at the admission time and 1 weak after hospitalization.
Results: Daily dexamethasone treatment was associated with a significant reduction in IL-6 and TNF-α, and a significant increase in IL-10 concentrations in all COVID 19 pneumonia patients with or without pre-existing COPD. Also a significant reduction in cortisol, CRP, LDH was observed following dexamethasone administration in all COVID 19 pneumonia patients with or without pre-existing COPD with no correlation with gender, cigarette and waterpipe smoking & opium abuse.
Conclusion: Our findings suggest a relationship among TNF-a, IL-6, IL-10, cortisol, LDH & CRP in critically ill COVID 19 pneumonia patients. Dexamethasone administration was associated with significant reduction in the markers of pro-inflammatory cytokines and cortisol, as well as significant reduction of LDH and CRP as the indicator markers of COVID 19 severity.