Use of different options of anti-inflammatory therapy in patients with severe COVID-19




SARS-nCoV-2, COVID-19, hypoxemic respiratory failure, acute respiratory distress syndrome, respiratory support, cytokine storm


The aim of the study. To compare the effectiveness of methylprednisolone, dexamethasone and tocilizumab in patients with severe coronavirus disease. Identify the most appropriate treatment option.

Materials and methods. Patients of group 1 (n=20) received for anti-inflammatory purposes tocilizumab at a dose of 600–800 mg. Patients in group 2 (n=82) received pulse therapy with methylprednisolone. Patients in group 3 (n=20) received dexamethasone 6 mg / day. Data are presented as M [25–75]. Statistical analysis of the results was performed using the program "Statistica 10". Significance of differences in indicators was assessed using the nonparametric Wilcoxon test. The results were considered reliable at values of p <0.05.

Results. The severe course of coronavirus disease with the development of cytokine storm and respiratory distress syndrome is characterized by an increase in markers of inflammation: in group 1 the median CRP was 89.2 g / l, in group 2 – 64.2 g / l, and in 3 – 76.2 g / l, and did not differ significantly between groups (p> 0.05). The level of IL-6 in group 1 was 61.8 pg / ml, in group 2 – 64.6 pg / ml, and in group 3 – 46.5 pg / ml without significant differences between groups (p> 0.05). The level of ferritin in all groups exceeded normal values.

Conclusions The most favourable result was obtained when using methylprednisolone: it was possible to reduce the mortality rate to 59.8 %. The relative risk of developing VTE was significantly higher in groups 1 and 3 (RR12 6.8 [2.7–16.8] p12 <0.0001, RR23 0.15 [0.06–0.35] p23 <0.0001), which gives grounds to confirm the presence of anticoagulant activity in methylprednisolone

Author Biography

Vita Skoryk, Kharkiv Medical Academy of Postgraduate Education

Postgraduate Student

Department of Anesthesiology, Pediatric Anesthesiology and Intensive Care


Hardy, R. S., Raza, K., Cooper, M. S. (2020). Therapeutic glucocorticoids: mechanisms of actions in rheumatic diseases. Nature Reviews Rheumatology, 16 (3), 133–144. doi:

Xu, Z., Shi, L., Wang, Y., Zhang, J., Huang, L., Zhang, C. et. al. (2020). Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine, 8 (4), 420–422. doi:

Meduri, G. U., Bridges, L., Shih, M.-C., Marik, P. E., Siemieniuk, R. A. C., Kocak, M. (2015). Prolonged glucocorticoid treatment is associated with improved ARDS outcomes: analysis of individual patients’ data from four randomized trials and trial-level meta-analysis of the updated literature. Intensive Care Medicine, 42 (5), 829–840. doi:

Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S. et. al. (2020). Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine, 180 (7), 934. doi:

Zhou, W., Liu, Y., Tian, D., Wang, C., Wang, S., Cheng, J. et. al. (2020). Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia. Signal Transduction and Targeted Therapy, 5 (1). doi:

Wang, Y., Jiang, W., He, Q., Wang, C., Wang, B., Zhou, P. et. al. (2020). A retrospective cohort study of methylprednisolone therapy in severe patients with COVID-19 pneumonia. Signal Transduction and Targeted Therapy, 5 (1). doi:

Zha, L., Li, S., Pan, L., Tefsen, B., Li, Y., French, N. et. al. (2020). Corticosteroid treatment of patients with coronavirus disease 2019 (COVID‐19). Medical Journal of Australia, 212 (9), 416–420. doi:

Veronese, N., Demurtas, J., Yang, L., Tonelli, R., Barbagallo, M., Lopalco, P. et. al. (2020). Use of Corticosteroids in Coronavirus Disease 2019 Pneumonia: A Systematic Review of the Literature. Frontiers in Medicine, 7. doi:

Dexamethasone in Hospitalized Patients with Covid-19 (2021). New England Journal of Medicine, 384 (8), 693–704. doi:

Fadel, R., Morrison, A. R., Vahia, A., Smith, Z. R., Chaudhry, Z. et. al. (2020). Early Short-Course Corticosteroids in Hospitalized Patients With COVID-19. Clinical Infectious Diseases, 71 (16), 2114–2120. doi:

Ye, Z., Wang, Y., Colunga-Lozano, L. E., Prasad, M., Tangamornsuksan, W., Rochwerg, B. et. al. (2020). Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis. Canadian Medical Association Journal, 192 (27), E756–E767. doi:

Zou, L., Ruan, F., Huang, M., Liang, L., Huang, H., Hong, Z. et. al. (2020). SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. New England Journal of Medicine, 382 (12), 1177–1179. doi:

Orhanizatsiia nadannia medychnoi dopomohy khvorym na koronavirusnu khvorobu (COVID-19) (2020). Nakaz MOZ Ukrainy No. 722. 28.03.2020. Available at:

Pro zatverdzhennia protokolu «Nadannia medychnoi dopomohy dlia likuvannia koronavirusnoi khvoroby (COVID-19)» (2020). Nakaz MOZ Ukrainy No. 762. 02.04.2020. Available at:

Pro vnesennia zmin do protokolu «Nadannia medychnoi dopomohy dlia likuvannia koronavirusnoi khvoroby (COVID-19)» (2020). Nakaz MOZ Ukrainy No. 852. 10.04.2020. Available at:

Pro vnesennia zmin do dodatku 6 Standartiv medychnoi dopomohy Koronavirusna khvoroba (COVID-19) (2020). Nakaz MOZ Ukrainy No. 994. 30.04.2020. Available at:

Ranieri, V. M., Rubenfeld, G. D., Thompson, B. T., Ferguson, N. D., Caldwell, E., Fan, E. et. al. (2012). Acute respiratory distress syndrome: the Berlin Definition. JAMA, 307 (23), 2526–2633. doi:

Luo, P., Liu, Y., Qiu, L., Liu, X., Liu, D., Li, J. (2020). Tocilizumab treatment in COVID‐19: A single center experience. Journal of Medical Virology, 92 (7), 814–818. doi:

Sciascia, S., Aprà, F., Baffa, A., Baldovino, S., Boaro, D., Boero, R. et. al. (2020). Pilot prospective open, single arm multicentre study on off-label use of tocilizumab in patients with severe COVID-19. Clinical and Experimental Rheumatology, 38 (3), 529–532.

Somers, E. C., Eschenauer, G. A., Troost, J. P., Golob, J. L., Gandhi, T. N., Wang, L. et. al. (2020). Tocilizumab for treatment of mechanically ventilated patients with COVID-19. medRxiv 2020. doi:

Guaraldi, G., Meschiari, M., Cozzi-Lepri, A., Milic, J., Tonelli, R., Menozzi, M. et. al. (2020). Tocilizumab in patients with severe COVID-19: a retrospective cohort study. The Lancet Rheumatology, 2 (8), e474–e484. doi:

Rimland, C. A., Morgan, C. E., Bell, G. J., Kim, M. K., Hedrick, T., Marx, A. et. al. (2020). Clinical characteristics and early outcomes in patients with COVID-19 treated with tocilizumab at a United States academic center. medRxiv 2020. doi:

Campochiaro, C., Della-Torre, E., Cavalli, G., De Luca, G., Ripa, M., Boffini, N. et. al. (2020). Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study. European Journal of Internal Medicine, 76, 43–49. doi:




How to Cite

Skoryk, V. (2021). Use of different options of anti-inflammatory therapy in patients with severe COVID-19. ScienceRise: Medical Science, (5(44), 22–27.



Medical Science