Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19
Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd..
INTRODUCTION: There is strong evidence for the use of corticosteroid in the management of severe coronavirus disease-2019 (COVID-19). However, there is still uncertainty about the timing of corticosteroids. We undertook a modified Delphi study to develop expert consensus statements on the early identification of a subset of patients from non-severe COVID-19 who may benefit from using corticosteroids.
METHODS: A modified Delphi was conducted with two anonymous surveys between April 30, 2021, and May 3, 2021. An expert panel of 35 experts was selected and invited to participate through e-mail. The consensus was defined as >70% votes in multiple-choice questions (MCQ) on Likert-scale type statements, while strong consensus as >90% votes in MCQ or >50% votes for "very important" on Likert-scale questions in the final round.
RESULTS: Twenty experts completed two rounds of the survey. There was strong consensus for the increased work of breathing (95%), a positive six-minute walk test (90%), thorax computed tomography severity score of >14/25 (85%), new-onset organ dysfunction (using clinical or biochemical criteria) (80%), and C-reactive protein >5 times the upper limit of normal (70%) as the criteria for patients' selection. The experts recommended using oral or intravenous (IV) low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days and monitoring of oxygen saturation, body temperature, clinical scoring system, blood sugar, and inflammatory markers for any "red-flag" signs.
CONCLUSION: The experts recommended against indiscriminate use of corticosteroids in mild to moderate COVID-19 without the signs of clinical worsening. Oral or IV low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days are recommended for patients with features of disease progression based on clinical, biochemical, or radiological criteria after 5 days from symptom onset under close monitoring.
HOW TO CITE THIS ARTICLE: How to cite this article: Nasa P, Chaudhry D, Govil D, Daga MK, Jain R, Chhallani AA, et al. Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19. Indian J Crit Care Med 2021;25(11):1280-1285.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
|---|---|
| Enthalten in: |
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine - 25(2021), 11 vom: 01. Nov., Seite 1280-1285 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Nasa, Prashant [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Corticosteroids in moderate COVID-19 |
|---|
| Anmerkungen: |
Date Revised 28.04.2022 published: Print Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.5005/jp-journals-10071-23923 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334035546 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334035546 | ||
| 003 | DE-627 | ||
| 005 | 20231225222856.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.5005/jp-journals-10071-23923 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1113.xml |
| 035 | |a (DE-627)NLM334035546 | ||
| 035 | |a (NLM)34866826 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Nasa, Prashant |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19 |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 28.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. | ||
| 520 | |a INTRODUCTION: There is strong evidence for the use of corticosteroid in the management of severe coronavirus disease-2019 (COVID-19). However, there is still uncertainty about the timing of corticosteroids. We undertook a modified Delphi study to develop expert consensus statements on the early identification of a subset of patients from non-severe COVID-19 who may benefit from using corticosteroids | ||
| 520 | |a METHODS: A modified Delphi was conducted with two anonymous surveys between April 30, 2021, and May 3, 2021. An expert panel of 35 experts was selected and invited to participate through e-mail. The consensus was defined as >70% votes in multiple-choice questions (MCQ) on Likert-scale type statements, while strong consensus as >90% votes in MCQ or >50% votes for "very important" on Likert-scale questions in the final round | ||
| 520 | |a RESULTS: Twenty experts completed two rounds of the survey. There was strong consensus for the increased work of breathing (95%), a positive six-minute walk test (90%), thorax computed tomography severity score of >14/25 (85%), new-onset organ dysfunction (using clinical or biochemical criteria) (80%), and C-reactive protein >5 times the upper limit of normal (70%) as the criteria for patients' selection. The experts recommended using oral or intravenous (IV) low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days and monitoring of oxygen saturation, body temperature, clinical scoring system, blood sugar, and inflammatory markers for any "red-flag" signs | ||
| 520 | |a CONCLUSION: The experts recommended against indiscriminate use of corticosteroids in mild to moderate COVID-19 without the signs of clinical worsening. Oral or IV low-dose corticosteroids (the equivalent of 6 mg/day dexamethasone) for 5-10 days are recommended for patients with features of disease progression based on clinical, biochemical, or radiological criteria after 5 days from symptom onset under close monitoring | ||
| 520 | |a HOW TO CITE THIS ARTICLE: How to cite this article: Nasa P, Chaudhry D, Govil D, Daga MK, Jain R, Chhallani AA, et al. Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19. Indian J Crit Care Med 2021;25(11):1280-1285 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Corticosteroids in moderate COVID-19 | |
| 650 | 4 | |a Delphi study | |
| 650 | 4 | |a Non-severe COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 700 | 1 | |a Chaudhry, Dhruva |e verfasserin |4 aut | |
| 700 | 1 | |a Govil, Deepak |e verfasserin |4 aut | |
| 700 | 1 | |a Daga, Mradul K |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Ravi |e verfasserin |4 aut | |
| 700 | 1 | |a Chhallani, Akshaykumar A |e verfasserin |4 aut | |
| 700 | 1 | |a Krishna, Apoorv |e verfasserin |4 aut | |
| 700 | 1 | |a Jagiasi, Bharat G |e verfasserin |4 aut | |
| 700 | 1 | |a Juneja, Deven |e verfasserin |4 aut | |
| 700 | 1 | |a Barthakur, Himadri S |e verfasserin |4 aut | |
| 700 | 1 | |a Jha, Hrishikesh |e verfasserin |4 aut | |
| 700 | 1 | |a Gurjar, Mohan |e verfasserin |4 aut | |
| 700 | 1 | |a Rangappa, Pradeep |e verfasserin |4 aut | |
| 700 | 1 | |a Aladakatti, Raghunath |e verfasserin |4 aut | |
| 700 | 1 | |a Mishra, Rajesh C |e verfasserin |4 aut | |
| 700 | 1 | |a Shetty, Rajesh M |e verfasserin |4 aut | |
| 700 | 1 | |a Yadav, Rohit |e verfasserin |4 aut | |
| 700 | 1 | |a Garg, Sandeep |e verfasserin |4 aut | |
| 700 | 1 | |a Nandakumar, Sivakumar M |e verfasserin |4 aut | |
| 700 | 1 | |a Samavedam, Srinivas |e verfasserin |4 aut | |
| 700 | 1 | |a Ray, Sumit |e verfasserin |4 aut | |
| 700 | 1 | |a Hadda, Vijay |e verfasserin |4 aut | |
| 700 | 1 | |a Javeri, Yash |e verfasserin |4 aut | |
| 700 | 1 | |a Munjal, Manish |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine |d 2008 |g 25(2021), 11 vom: 01. Nov., Seite 1280-1285 |w (DE-627)NLM191247936 |x 0972-5229 |7 nnns |
| 773 | 1 | 8 | |g volume:25 |g year:2021 |g number:11 |g day:01 |g month:11 |g pages:1280-1285 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.5005/jp-journals-10071-23923 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 25 |j 2021 |e 11 |b 01 |c 11 |h 1280-1285 | ||