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Preprint / Not Peer Reviewed — NOT PEER REVIEWED Early Low-dose, Short-term Corticosteroid Treatment

Preprint / Not Peer Reviewed — NOT PEER REVIEWED Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia (China) Source: Wang Y, et al. Med. Rxiv. doi. org/10. 1101/2020. 03. 06. 20032342.

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Design Study Design

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Design Study Design • Background: Retrospective study of the clinical and radiographic outcomes of early, lowdose, corticosteroid treatment in 26 patients with severe COVID-19 pneumonia in Wuhan, China during January 20, 2020 to February 25, 2020. • Primary Outcome: - Clinical symptoms and chest computed tomography (CT) • Inclusion Criteria: - PCR positive throat swab for SARS-Co. V-2 - Severe COVID-19 pneumonia: o Respiratory Rate ≥ 30/min o Sp. O 2 ≤ 93% at rest o Pa. O 2: Fi. O 2 ≤ 300 mm. Hg - Other high-risk condition • Evaluated Treatment Groups: - Methylprednisolone treatment with the dosage of 1 - 2 mg/kg/d IV for 5 -7 days (n = 26) - Patients who did not receive methylprednisolone (n = 20) • Duration of follow up: - End of hospitalization Source: Wang Y, et al. Med. Rxiv doi. org/10. 1101/2020. 03. 06. 20032342.

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Baseline Characteristics Methylprednisolone

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Baseline Characteristics Methylprednisolone (n = 26) No Methylprednisolone (n =20) Age, years, median (IQR) 54 (48 – 63) 53 (48 – 63) 16 (62) 10 (50) Hypertension 8 (31) 6 (30) Chronic cardiac disease 3 (12) 3 (15) Chronic pulmonary disease 1 (3. 9) 2 (10) 37. 6 (36. 7 – 38. 0) 38. 2 (36. 8 – 38. 6) Respiratory Rate, per min* 28 (21 – 36) 24 (20 – 30) Sp. O 2 at rest, % 91 (88 – 92) 90 (85 – 92) Male, n (%) Coexisting conditions, n (%) Vital signs, mean (IQR) Temperature, ºC *Indicates P value <0. 05 Source: Wang Y, et al. Med. Rxiv doi. org/10. 1101/2020. 03. 06. 20032342

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Results (n =

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Results (n = 26) No Methylprednisolone (n = 20) • Three patients. Methylprednisolone died during hospitalization 100 Improvement in Sp. O 2 (%) - 89 year-old man with end-stage prostate cancer died of 96, 2 multiorgan failure 84, 6 80 - 51 year-old woman with diabetic foot and gangrene - 49 year-old man died of respiratory 69, 2 failure 65, 4 60 61, 5 70, 0 60, 0 • Days to fever resolution was significantly fewer in the methylprednisolone group (2. 06 ± 0. 28 vs. 4. 39 ± 0. 70, P=0. 010) 40 42, 3 35, 0 • Patients who recieved methylprednisolone required fewer days of 20 supplemental oxygen 20, 0 (8. 2 days 20, 0 [IQR 7. 0 - 10. 3] vs. 13. 5 days [IQR 10. 3 -16]; P <0. 001) 0 2 3 4 5 6 Days following Methylprednisolone Therapy Source: Wang Y, et al. Med. Rxiv doi. org/10. 1101/2020. 03. 06. 20032342 7

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Results Comparison of

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Results Comparison of the dynamic change of Sp. O 2 with and without Methylprednisolone treatment: Trend of Sp. O 2 Change and Comparison for Sp. O 2 on Daily Basis Methylprednisolone treatment Non-Methylprednisolone treatment Source: Wang Y, et al. Med. Rxiv doi. org/10. 1101/2020. 03. 06. 20032342

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Authors’ Conclusions: “Our

Early Low-dose, Short-term Corticosteroid Treatment in Patients with Severe COVID-19 Pneumonia: Authors’ Conclusions: “Our data indicate that in patients with severe COVID-19 pneumonia, early, low-dose and short-term application of corticosteroid was associated with a faster improvement of clinical symptoms and absorption of lung focus. ” Source: Wang Y, et al. Med. Rxiv doi. org/10. 1101/2020. 03. 06. 20032342