Precaución con el uso de dexametasona en pacientes con COVID-19 en sus fases iniciales / Caution with the use of dexamethasone in patients with COVID-19 in its initial phases

Introducción El efecto de la dexametasona en la fase inicial de la infección por SARS-CoV-2 y su influencia sobre la COVID-19 no está bien definido. Describimos las características clínico-radiológicas, los parámetros de tormenta de citoquinas y la evolución clínica de una serie de pacientes tratados con dexametasona en la fase inicial de la enfermedad. Método Estudio de 8 pacientes que recibieron dexametasona previo al desarrollo de la COVID-19. Evaluamos variables clínicas, pruebas de imagen, parámetros de liberación de citoquinas, tratamiento empleado y su evolución. Resultados Todos los pacientes recibieron una dosis de 6mg/día con una duración media de 4,5 días previos al ingreso. La mayoría de los pacientes presentaron una extensión grave en la tomografía computarizada de alta resolución (TCAR) y una elevación leve de los parámetros de liberación de citoquinas; 3 pacientes requirieron oxigenoterpia nasal de alto flujo (ONAF) por insuficiencia respiratoria, y ningún paciente requirió intubación orotraqueal ni falleció. Conclusión La dexametasona en las fases iniciales de la infección por SARS-CoV-2 parece asociarse con una COVID-19 grave (AU)

Introduction The effect of dexamethasone in the initial phase of infection by SARS-CoV-2 and its influence on COVID-19 is not well defined. We describe clinical-radiological characteristics, the cytokine storm parameters, and the clinical evolution of a series of patients treated with dexamethasone in the disease's initial phase. Method A study of 8 patients who received dexamethasone before the development of COVID-19. We evaluate clinical variables, imaging tests, cytokine release parameters, treatment used and patient evolution. Results All patients received a 6mg/day dose with a mean duration of 4.5 days before admission. High resolution computed tomography (HRCT) revealed that most of them presented a severe extension; most patients had a slightly elevated level of cytokine release parameters. Three patients required high-flow oxygen therapy due to respiratory failure; none required orotracheal intubation or died. Conclusion Dexamethasone in the early stages of SARS-CoV-2 infection appears to be associated with severe COVID-19 (AU)

Caution with the use of dexamethasone in patients with COVID-19 in its initial phases.

INTRODUCTION: The effect of dexamethasone in the initial phase of infection by SARS-CoV-2 and its influence on COVID-19 is not well defined. We describe clinical-radiological characteristics, the cytokine storm parameters, and the clinical evolution of a series of patients treated with dexamethasone in the disease's initial phase. METHOD: A study of 8 patients who received dexamethasone before the development of COVID-19. We evaluate clinical variables, imaging tests, cytokine release parameters, treatment used and patient evolution. RESULTS: All patients received a 6 mg/day dose with a mean duration of 4.5 days before admission. High resolution computed tomography (HRCT) revealed that most of them presented a severe extension; most patients had a slightly elevated level of cytokine release parameters. Three patients required high-flow oxygen therapy due to respiratory failure; none required orotracheal intubation or died. CONCLUSION: Dexamethasone in the early stages of SARS-CoV-2 infection appears to be associated with severe COVID-19.

[Caution with the use of dexamethasone in patients with COVID-19 in its initial phases]. / Precaución con el uso de dexametasona en pacientes con COVID-19 en sus fases iniciales.

INTRODUCTION: The effect of dexamethasone in the initial phase of infection by SARS-CoV-2 and its influence on COVID-19 is not well defined. We describe clinical-radiological characteristics, the cytokine storm parameters, and the clinical evolution of a series of patients treated with dexamethasone in the disease's initial phase. METHOD: A study of 8 patients who received dexamethasone before the development of COVID-19. We evaluate clinical variables, imaging tests, cytokine release parameters, treatment used and patient evolution. RESULTS: All patients received a 6 mg/day dose with a mean duration of 4.5 days before admission. High resolution computed tomography (HRCT) revealed that most of them presented a severe extension; most patients had a slightly elevated level of cytokine release parameters. Three patients required high-flow oxygen therapy due to respiratory failure; none required orotracheal intubation or died. CONCLUSION: Dexamethasone in the early stages of SARS-CoV-2 infection appears to be associated with severe COVID-19.

Mujer de 42 años con pancitopenia / A 42 year-old woman with pancytopenia

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