Dexamethasone Treatment Considerably Reduces the Levels of Some Inflammatory Cytokines, Lactate Dehydrogenase, and C-Reactive Protein in COVID-19 Pneumonia Patients With Pre-existing COPD

Background: Dexamethasone is the most widely used corticosteroid for treating COVID-19 pulmonary complications. The effects of dexamethasone on serum inflammatory factors, including C-reactive protein (CRP), lactate dehydrogenase (LDH), and cortisol, were evaluated in COVID-19 pneumonia patients with pre-existing chronic obstructive pulmonary disease (COPD) in this study.Methods: A total of 36 COVID-19 patients with pneumonia who had pre-existing COPD and were critically ill and 56 COVID-19- positive patients without pre-existing COPD were selected. A daily dose of 6–8 mg dexamethasone was administered during the hospitalization period. Some inflammatory markers (TNF-α, IL-10, and IL-6) and the serum levels of cortisol, LDH, and CRP were measured on admission and one week after hospitalization.Results: TNF-α and IL-6 concentrations were significantly reduced and IL-10 significantly increased in all COVID-19 pneumonia patients with or without pre-existing COPD as a result of a daily dose of dexamethasone. Also, a significant reduction in cortisol, CRP, and LDH was observed following dexamethasone administration in all COVID-19 pneumonia patients, with or without preexisting COPD, with no correlation with gender, cigarette or waterpipe smoking, or opium abuse.Conclusion: Our results showed a significant increase in TNF-α, IL-6, IL-10, cortisol, LDH, and CRP and a significant reduction in IL-10 in all critically ill COVID-19 pneumonia patients. Dexamethasone administration significantly reduced cortisol and proinflammatory cytokines and also LDH and CRP as the markers of COVID-19 severity.