[Retrospective analysis of the corticosteroids treatment on severe acute respiratory syndrome (SARS)].

Li, Nan; Ma, Jing; Nie, Ligong; Li, Haichao; Que, Chengli; Gao, Zhidong; Wang, Guangfa; Xu, Xiaoyuan; Lu, Haiying; Wang, Guiqiang

OBJECTIVE To analyze the usage of corticosteroids in the treatment of SARS. METHODS The usage of corticosteroids in 43 SARS patients were reviewed. The initial dosage and the highest dosage of prednisolone were investigated. RESULTS According to the dosage of the early 3 days, the initial dosage was calculated. The initial methyprednisonlone dosage was (170.82 +/- 15.89) mg.d-1, from 48 to 500 mg.d-1. The maximal dosage was (291.44 +/- 37.63) mg.d-1 (48-800 mg.d-1). Four patients recovered without corticosteroides therapy. Initial therapy was kept in 25 cases. Two had hyperglycemia, one of whom died of hyperosmotic coma and renal failure. 14 cases were not responsive and needed to increase the dosage of corticosteroids. 9 of them accepted pulse dosage therapy and acquired good outcome. None in the group had significant side effect. The severity of patients of the two groups had no significant difference. Those of nonresponsiveness had higher dosage and needed longer time to reach stable. CONCLUSION Sub-pulse dosage of methyprednisolone was effective for most SARS patients. Those who were less responsiveness might due to their poor sensitiveness to corticosteroids instead of SARS severity. Pulse treatment might be safe in carefully selected patients.