Main Article Content
COVID-19, Patients, Risks, Population, Treatment, Outcomes
Introduction: The World Health Organization (WHO) announced the coronavirus disease 2019 (COVID-19) occurrence as a global pandemic in March 2020.
Objectives: The basic aim of the study is to find the effects of arthritis drugs and steroids drugs to save COVID-19 patients’ life.
Material and methods: This retrospective cohort study was conducted in Lady Reading Hospital, Peshawar from October 2022 to march 2023. Ethical approval was obtained from the institutional review board (IRB) before the commencement of data collection.The study included a total of 420 COVID-19 patients who met the inclusion criteria and were divided into four groups based on the treatments they received: arthritis drugs (Group A), steroid medications (Group B), combination therapy with both arthritis drugs and steroids (Group C), and standard care (Group D).
Results: Data was collected from 420 patients suffering from COVID-19. The mean age of the study population was 52.5±8.2 years. 56% of the participants were male, and 44% were female. Common comorbidities among the patients included hypertension (32%), diabetes (24%), and cardiovascular disease (18%), with 82% of patients having at least one comorbidity.
Conclusion: It is concluded that steroids, commonly used for arthritis, may improve outcomes in COVID-19 patients with comorbidities. Individualized treatment decisions considering benefits and risks are crucial in COVID-19 management.
2. Jha N.K., Jeyaraman M., Rachamalla M., Ojha S., Dua K., Chellappan D.K., Muthu S., Sharma A., Jha S.K., Jain R., Jeyaraman N., Gs P., Satyam R., Khan F., Pandey P., Verma N., Singh S.K., Roychoudhury S., Dholpuria S., Ruokolainen J., Kesari K.K. Current understanding of novel coronavirus: molecular pathogenesis, diagnosis, and treatment approaches. Immuno. 2021;1:30–66. doi: 10.3390/IMMUNO1010004. 2021. 30-66 1.
3. Kalfaoglu B., Almeida-Santos J., Tye C.A., Satou Y., Ono M. T-cell hyperactivation and paralysis in severe COVID-19 infection revealed by single-cell analysis. Front. Immunol. 2020;11 doi: 10.3389/FIMMU.2020.589380.
4. Liu J., Zhang S., Dong X., Li Z., Xu Q., Feng H., Cai J., Huang S., Guo J., Zhang L., Chen Y., Zhu W., Du H., Liu Y., Wang T., Chen L., Wen Z., Annane D., Qu J., Chen D. Corticosteroid treatment in severe COVID-19 patients with acute respiratory distress syndrome. J. Clin. Invest. 2020;130:6417–6428. doi: 10.1172/JCI140617.
5. Nelson B.C., Laracy J., Shoucri S., Dietz D., Zucker J., Patel N., Sobieszczyk M.E., Kubin C.J., Gomez-Simmonds A. Clinical outcomes associated with methylprednisolone in mechanically ventilated patients with COVID-19. Clin. Infect. Dis. 2021;72:e367–e372.
6. Ramiro S., Mostard R.L.M., Magro-Checa C., van Dongen C.M.P., Dormans T., Buijs J., Gronenschild M., de Kruif M.D., van Haren E.H.J., van Kraaij T., Leers M.P.G., Peeters R., Wong D.R., Landewé R.B.M. Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study. Ann. Rheum. Dis. 2020;79:1143–1151. doi: 10.1136/ANNRHEUMDIS-2020-218479.
7. Sarkar S., Khanna P., Soni K.D. Are the steroids a blanket solution for COVID-19? A systematic review and meta-analysis. J. Med. Virol. 2021;93:1538–1547.
8. Sunkara H., Dewan S.M.R. Coronavirus disease-2019: a review on the disease exacerbation via cytokine storm and concurrent management. Int. Immunopharm 2021;99
9. Van Paassen J., Vos J.S., Hoekstra E.M., Neumann K.M.I., Boot P.C., Arbous S.M. Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes. Crit. Care. 2020;24:696. doi: 10.1186/S13054-020-03400-9.
10. World Health Organization (WHO) Clinical management of severe acute respiratory infection ( SARI) when COVID-19 disease is suspected: interim guidance. 2020.
https://apps.who.int/iris/handle/10665/331446 13th March 2020. Avialble at. Accessed on 9th April 2021.
11. Yan T., Xiao R., Wang N., Shang R., Lin G. Obesity and severe coronavirus disease 2019: molecular mechanisms, paths forward, and therapeutic opportunities. Theranostics 2021;11:8234–8253. doi: 10.7150/THNO.59293.
12. Patel, Vijay K., et al. "Corticosteroids for Treatment of COVID-19: Effect, Evidence, Expectation and Extent." Beni-Suef University Journal of Basic and Applied Sciences, vol. 10, no. 1, 2021, https://doi.org/10.1186/s43088-021-00165-0.
13. Weiss SR, Navas-Martin S. Coronavirus pathogenesis and the emerging pathogen severe acute respiratory syndrome coronavirus. Microbiol Mol Biol Rev. 2005;69(4):635–664.
14. Zhong N, Zheng B, Li Y, Poon L, Xie Z, Chan K, Li P, Tan S, Chang Q, Xie J. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003. Lancet. 2003;362(9393):1353–1358.
15. Li H, Liu S-M, Yu X-H, Tang S-L, Tang C-K. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents. 2020;55(5):105951.
16. Schultze A, Walker AJ, MacKenna B, Morton CE, Bhaskaran K, Brown JP, Rentsch CT, Williamson EJ, Drysdale H, Croker R, Bacon S, Hulme WJ, Bates C, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, Tomlinson L, Mathur R, Wing K, Wong AY, Forbes H, Parry J, Hester F, Harper S, Evans SJ, Quint J, Smeeth L, Douglas IJ, Goldacre B. Inhaled corticosteroid use and risk COVID-19 related death among 966,461 patients with COPD or asthma: an OpenSAFELY analysis. medRxiv. 2020
17. Amponsah, Seth K., et al. "Efficacy and Safety Profile of Corticosteroids and Non-steroidal Anti-inflammatory Drugs in COVID-19 Management: A Narrative Review." Frontiers in Pharmacology, vol. 13, 2022, p. 1063246, https://doi.org/10.3389/fphar.2022.1063246.
18. Dequin, P. F., Heming, N., Meziani, F., Plantefève, G., Voiriot, G., Badié, J., et al. (2020). Effect of hydrocortisone on 21-day mortality or respiratory support among critically ill patients with COVID-19: A randomized clinical trial. JAMA - J. Am. Med. Assoc. 324, 1298–1306. doi:10.1001/jama.2020.16761
19. Dilly, S., FotsoFotso, A., Lejal, N., Zedda, G., Chebbo, M., Rahman, F., et al. (2018). From naproxen repurposing to naproxen analogues and their antiviral activity against influenza A virus. J. Med. Chem. 61, 7202–7217. doi:10.1021/acs.jmedchem.8b00557
20. Fang, L., Karakiulakis, G., and Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet. Respir. Med. 8, e21. doi:10.1016/S2213-2600(20)30116-8
21. Heijnen, N. F. L., Hagens, L. A., Smit, M. R., Schultz, M. J., van der Poll, T., Schnabel, R. M., et al. (2021). Biological subphenotypes of acute respiratory distress syndrome may not reflect differences in alveolar inflammation. Physiol. Rep. 9 (3), e14693. doi:10.14814/phy2.14693