The peripheral lymphocyte count as a predictor of severe COVID-19 and the effect of treatment with ciclesonide

• Published in: Virus research Vol. 290; p. 198089
• Main Authors: Yamasaki, Yukitaka, Ooka, Seido, Tsuchida, Tomoya, Nakamura, Yuta, Hagiwara, Yuta, Naitou, Yoshiyuki, Ishibashi, Yuki, Ikeda, Hiroki, Sakurada, Tsutomu, Handa, Hiroshi, Nishine, Hiroki, Takita, Mumon, Morikawa, Daiki, Yoshida, Hideki, Fujii, Shuichi, Morisawa, Kenichiro, Takemura, Hiromu, Fujitani, Shigeki, Kunishima, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2020; The Authors. Published by Elsevier B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers - blood; Ciclesonide; Coronavirus; COVID-19; COVID-19 - blood; COVID-19 - pathology; COVID-19 Drug Treatment; Female; Glucocorticoids - therapeutic use; Humans; Lymphocyte Count; Lymphocytes - pathology; Male; Middle Aged; Pneumonia; Pregnenediones - therapeutic use; Retrospective Studies; SARS-CoV-2; Treatment Outcome; Young Adult; COVID-19; Pneumonia; Coronavirus; Ciclesonide
• ISSN: 0168-1702; 1872-7492
• DOI: 10.1016/j.virusres.2020.198089

•Early diagnosis and prevention of aggravation are important in COVID-19 medical care.•Lymphocyte counts can be used to identify patients who may develop severe COVID-19.•The ciclesonide treatment group had a lower incidence of severe pneumonia.•The lymphocyte count after ciclesonide therapy was significantly higher compared to before treatment.•Treatment of the asthma drug ciclesonide may prevent severe pneumonia. We investigated whether reduced lymphocyte count, could predict the development of severe COVID-19. We also examined whether ciclesonide could prevent the development of severe COVID-19 among patients with the predictors. This was a retrospective cohort study. Of the 30 included patients, 12, 14, and 4 were allocated to severe pneumonia, non-severe pneumonia, and non-pneumonia groups, respectively. The group of the low level of lymphocyte counts of the sixth day after onset was significantly intubated approximately three days later. The incidence of the severe pneumoniae requiring intubation are significantly lower in the patients treated with ciclesonide than without it (11.18 % vs 83.33 %, p = 0.0033). The lymphocyte count after ciclesonide treatment in the non-severe pneumonia group was significantly higher (p = 0. 0156) than before. The lymphocyte count could be used to identify patients that may develop severe COVID-19. Treatment with ciclesonide may prevent the development of severe COVID-19.