Place of Corticotherapie in the Treatment of the COVID19
Dr. M. Bentrad*

*Corresponding Author: Dr. Mouloud Bentrad, pneumologue university of Algeria, Algeria.

Received Date:  November 27, 2020

Publication Date: December 01, 2020

Figure-1
With CTC j1 on corticotherapy on the1st day of treatment Without CTC j8 - corticosteroid therapy to be part of the 8th day Without CTC j 1 - without corticosteroid therapy as of the  1st  day of treatment.

A randomized retrospective study of a cohort of 90 patients COVID-19 PCR test; 

16 to 75 with male predominance ratio in two groups:  

1- GROUP A:  50 patients or 55.55%55 % of the cohort were put under 40 mg of prednisone on the1st day  

2-GROUP B: 40 patients or 44.44% were put on a protocol without corticosteroids for 7 days with the introduction of 40 mg of prednisone from the 8thème day.

3- EVOLUTION:

GROUP A: 50 patients on corticoid: 

 a) 28 patients (56%) have evolved well with complete healing without noticeable complication

b)11 patients (22%) developed an isolated dry cough without respiratory impairment

c)6 patients (12%) developed a productive fatty cough evoking mild over the infection.

D) 5 patients or 10% had an unfavourable evolution from the 3rd day of prednisone (unbalanced diabetes, HTA, Decompensated COPD).  

In total/ group A showed an evolution of 90% without any significant serious complications.

GROUP B: 40 Patients without corticosteroid:

- 14 patients, or 35%, had a slow and unfavourable progression on the 7thème day with cough and respiratory gene.  

Thorax CT objected to injuries ranging from 5% to 30% of the pulmonary interstitium, Spo2 in the safety interval (95-100%) in ( 95 85.71%; only 3 cases or 21.42% had spo2 -lt; 90% ).

- 26 patients or 47, 5% had a favourable but slow evolution accompanied by dry cough without a respiratory gene.  

IN total GROUP B showed a favourable evolution in 47.5% during the first week.

After the introduction of the prednisone at the beginning of the 2ndème week for 7 days, we had a remarkable evolution of subgroup 14 with the disappearance of all symptoms and net improvement of the general condition of the same for subgroup sous group 26 with a very favourable improvement and unfortunate complications were noted.

Biology in all patients was normal except: -15 CRP -6, lymphopenia observed in 88% of the, 800 500 chez 96,30% du Cohort.

Patients %

Figure-2

Discussion
According to the results found and illustrated by the above graph, there are three curves:

The green curve: witness

The blue curve: patients set on the beginning under corticoids (prednisone) for 10 days 

The red curve: patients puts or protocol without corticosteroid for 7 days with the introduction of corticosteroid at 8thème day and for 8 days.

The administration of corticosteroid therapy from the beginning of covid19 has brought us a significant rate of rapid cure. (blue curve) 

The evolution of patients on conventional treatment without corticosteroids appeared slow and unfavourable in the first week. The introduction of prednisone 40 mg per day at the end of the 1st week to change the pattern of the curve with a significant upturn in the cure rate during the 2nd week.

Conclusion
The introduction of corticosteroid therapy at the initial stage of viremia appeared to be very beneficial (despite some often benign side effects) it significantly reduces the immune storm of the 2nd week causing formidable complications by vascular endothelium and the resulting vascularity.

References
1.Medical medical practice records of pneumology DR M BENTRAD 1, course of the revolution ANNABA  Alegria.

2.Tests of PCR diagnostic covid 19 / ANNABA  HOSPITAL, Guelma Regional     Hospital, ANNABA Private  Medical Biology Laboratories. 

3.Microsoft Word Curves and Graphic Sectors

4.Statistical calculation: staff of DR BENTRAD.

Volume 1 Issue 4 December 2020

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