Nhận xét sự thay đổi lâm sàng, cận lâm sàng bệnh nhân mắc Covid-19 mức độ nguy kịch được điều trị bằng dexamethasone liều cao

Comment on the clinical and subclinical changes in the group of critically ill COVID-19 patients treated with high-dose Dexamethasone and dose according to the guidelines of the Ministry of Health. Subjects and methods: Prospective description on 43 patients over 18 years of age - diagnosed with severe COVID-19 at COVID 3 Unit - Duc Giang General Hospital from January 2022 to March 2022. Study patients were divided into 2 groups: Group I: treated with dexamethasone dose of 20 mg/day, reduced by ½ dose after 5 days until full 10 days. Group II: treated with dexamethasone at a dose of 50-100 mg/day, reduced by ½ dose every 3 days until full 10 days. Comment on clinical progress and paraclinical indicators according to treatment days. Results: The average age is 74.79 (49-97), the proportion of men is 44.3%, the rate of unvaccinated 53.5%. There was no difference in the average of the paraclinical indexes (BC Lymphoma, D-dimer, Fibrin, Ferritin, CRP, LDH, P/F, Brixia score) between the 2 groups of patients studied according to the treatment days. There was no difference in mortality rate, hospital-acquired infection rate, gastrointestinal bleeding rate, acute renal failure rate between the 2 study groups. The group of patients over 70 years old had a higher rate of death, acute renal failure, gastrointestinal bleeding than the group of patients under 70 years old (p < 0.05). The group of patients who received ≥ 2 doses of vaccine had a lower mortality rate (p < 0.05). Conclusion: There was not much difference in the effectiveness of treating patients with severe COVID-19 with dexamethasone at a dose of 50-100 mg/day compared with a dose of 20 mg/day. However, our study was small, and larger studies are needed to confirm this.