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21 July 2020: Articles

High-Dose Prednisone for Treatment of Autoimmune Pancreatitis in a Patient with Coronavirus Disease 2019 (COVID-19) due to Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Unusual clinical course, Unusual setting of medical care

Hammad Liaquat A* , Brittney Shupp B , Sarina Kapoor C , Ayaz Matin A

DOI: 10.12659/AJCR.926475

Am J Case Rep 2020; 21:e926475

Table 1. Studies demonstrating outcomes of corticosteroid use in patients with severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV).

OutbreakParticipantsMethodsOutcomes related to steroid useRef
SARS-CoV117 previously healthy patients with confirmed diagnosis of SARS-CoVCompared weekly qualitative CoV RT-PCR assays, chest XR, SARS-COV serology, and daily plasma SARS-CoV RNA concentrations between those who received hydrocortisone 100 mg q 8 hrs placebo groupEarly hydrocortisone initiation led to delayed viral clearance[]12
Compared 15 patients diagnosed with SARS related psychosis to 30 age and sex matched SARS control subjects with no diagnosis of psychosisReviewed the clinical data of SARS patients requiring psychiatric consultation and compared them with the charts of the control group to investigate risk factorsHigher rates of psychosis associated with higher cumulative corticosteroid doses[]14
133 confirmed SARS patients, including 95 who were prescribed glucocorticoidsReviewed the clinical data of SARS patients to determine fasting plasma glucose (FPG) levels and associated risk factorsElevated FPG and diagnosis of steroid-induced diabetes were associated with increased doses and duration of corticosteroids[]15
40 hospitalized patients with confirmed SARS infection3 months following discharge, SARS patients on corticosteroids were evaluated by MRI to detect avascular necrosis of the femoral head and with ultrasound of the left heel to determine osteoporosisIncreased cumulative dosing of corticosteroids led to higher incidence rates of osteoporosis and avascular necrosis[]16
MERS-CoV309 patients who met the MERS eligibility criteria, excluding patients with a history of chronic corticosteroid useAnalyzed the recorded data from a retrospective cohort hospital study involving 14 tertiary care hospitals in Saudi Arabia and compared corticosteroid use and viral RNA clearance in groups that were and were not treated with corticosteroids groupCorticosteroid use had no effect on 90-day mortality but was associated with delayed MERS-CoV RNA clearance[]13

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923