Although corticosteroid administration has been associated with improved outcomes in severe COVID-19 pneumonia, their ideal use remains undefined with a “one size fits all” approach used, irrespective of the individual inflammatory response.

Recent studies have highlighted distinct COVID-19 inflammatory phenotypes with differential responses to corticosteroids.

Our goal was to assess the feasibility and safety of an individualized, biomarker-guided corticosteroid dosing approach utilizing C-reactive protein (CRP) in patients with pneumonia and acute hypoxemic respiratory failure (AHRF).

With the COVID-19 outbreak, a separate COVID-19 trial arm was created.

The results of this single-center pilot randomized controlled clinical trial show that an individualized biomarker-guided corticosteroid dosing approach in pneumonia using CRP is feasible and safe with high adherence to the study protocol.

Although not powered to detect differences in patient-centered outcomes, the individualized CRP-guided corticosteroid dosing approach was associated with increased oxygen-free days, hospital-free days, and a lower corticosteroid cumulative exposure in the intervention arm.

Read More