AccScience Publishing / JCTR / Online First / DOI: 10.36922/jctr.24.00036
ORIGINAL ARTICLE

Dexamethasone in critical coronavirus disease-2019 cases: Insights from a cross-sectional study

Sayuri Rocha Yamashita1 Vera Lúcia Milani Martins2 Victor Iury Soares Santos Patrício3 Lúcia de Araújo Costa Beisl Noblat1 Francine Johansson Azeredo4*
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1 Department of Medicine, Graduate Program in Pharmaceutical Services and Policies, Federal University of Bahia, Salvador - Bahia, Brazil
2 Federal Institute of Education, Science and Technology of Rio Grande do Sul. R. Cel. Vicente, Porto Alegre - Rio Grande do Sul, Brazil
3 Intensive Care Unit, Hospital Santa Izabel, Salvador - Bahia, Brazil
4 Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics Lake Nona (Orlando), University of Florida, Orlando, Florida, United States of America
Submitted: 2 July 2024 | Revised: 24 October 2024 | Accepted: 8 January 2025 | Published: 5 February 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Objective: The objective of the study is to describe the clinical and laboratory characteristics of critically ill coronavirus disease-2019 (COVID-19) patients treated with dexamethasone in an intensive care unit (ICU) to provide a support tool for clinical decision-making. Design: A survey was conducted among hospitalized patients from November 2020 to March 2021, with data collected through patient interviews, medical records, and laboratory tests. Setting: This is a large hospital serving as a reference center for COVID-19 care in Bahia, Brazil. Patients: A convenience sample of 22 patients admitted to the COVID-19 ICU who signed informed consent to participate in the study. Methods: A cross-sectional study of patients admitted to the ICU with COVID-19. Data were analyzed using statistical methods. Results: The most common comorbidities among patients were hypertension (54%), diabetes (36%), and cardiovascular disease (27%). Among the deaths recorded, 55% of patients had hypertension, 44% had diabetes and/or required insulin therapy, 33% had a history of cardiovascular disease (including atrial fibrillation and congestive heart failure), and 22% had a history of stroke. Renal dysfunction (elevated creatinine); liver function abnormalities (increased alanine aminotransferase and aspartate aminotransferase); and elevated levels of ferritin, fibrinogen, and D-dimer were identified as potential indicators of disease progression. Among these factors, only elevated creatinine demonstrated a statistically significant association with an increased mortality risk. Conclusion: These findings provide a better understanding of the clinical course of severe acute respiratory syndrome coronavirus 2 infections and suggest that laboratory medicine is crucial in supporting clinical decision-making and advancing scientific and healthcare knowledge during the early phases of the COVID-19 pandemic. Relevance for patients: Identifying key risk factors, such as renal dysfunction, can improve early intervention and personalized treatment for critically ill COVID-19 patients.

Keywords
Intensive care unit
SARS-COV-2
Hospitalized patients
Clinical and laboratory features
Funding
The work was supported by the Capes Finance Code 001.
Conflict of interest
All authors report no conflicts of interest relevant to this article.
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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing