A simple blood test can identify which coronavirus patients can receive help from steroid treatments and which ones may be harmed by using them in the initial treatment of the disease.
Researchers from the Albert Einstein College of Medicine and the Montefiore Health System in the Bronx, NY, conducted an observational study that not only confirmed the results of a large British trial of steroid use for patients with COVID-19, but also advanced the study by identifying which patients may benefit and who would potentially be at risk from initial steroid treatment, according to the study.
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“Our study is consistent with the promising results from Britain, but for the first time, we can demonstrate that people can see the same life-saving benefits with steroid formulations other than dexamethasone,” said Dr. Marla Keller, vice president of Research at the Einstein and Montefiore Department of Medicine, in a hospital press release.
“We also found that a common blood test can identify the best candidates for steroid treatment,” added Keller, lead author of the study.
Almost 3,000 hospitalized patients in Montefiore who tested positive for COVID-19 participated in the study. A group of 140 patients received steroids in the form of prednisone, dexamethasone, and methylprednisone within 48 hours of their hospital admission. Almost all of the patients underwent a blood test to measure the amount of inflammation in their bodies by measuring their level of C-reactive protein (PCR).
PCR occurs in your body in response to inflammation, and higher levels correlate with higher amounts of inflammation present. A normal CRP level reported in the study is less than 0.8 milligrams per deciliter of blood.
“We found that in patients with high levels of inflammation, that is, a CRP level greater than 20, steroids were associated with a 75 percent reduction in the risk of mechanical ventilation or dying,” Keller said in the statement. “Critically, we also found that for patients with a lower level of inflammation (CRP levels less than 10), steroid use was associated with an almost 200 percent increased risk of mechanical ventilation or death.”
Health experts have said that many coronavirus-related deaths are due to the body’s intense inflammatory response, which results in severe lung damage.
“Our findings suggest that steroid therapy should be reserved for people with high inflammation, as indicated by markedly elevated CRP levels,” said Dr. William Southern, professor of medicine and chief of the Division of Hospital Medicine at Einstein and Montefiore. , in the statement. .
“It’s a different story for people who don’t have significant inflammation: For them, any benefit is outweighed by the risks of steroid use,” added Southern, lead author of the study.
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The Bronx-based study expanded into a large-scale British study called the RECOVERY trial that found dexamethasone, a steroid, can reduce COVID-19-related deaths by one-third in ventilated patients and by one-fifth in other patients. who required oxygen supplementation. The study found that steroids did not benefit and could possibly harm patients who did not need additional oxygen to breathe.
The study from the Albert Einstein College of Medicine and the Montefiore Health System was published this week in the peer-reviewed Journal of Hospital Medicine.
