MDR in severely ill COVID-19 patients
During the first peak of the COVID-19 pandemic in March/April 2020 in
Europe, we treated 12 severely COVID-19 affected patients with MDR
(Table 1). Based on the clinical presentation and medication history, we
made the diagnosis of a MDR. Proton-pump inhibitors were suspected as
culprit drugs in 7/12 cases, antibiotics in 4 cases. Ten out of 12
patients were male, the mean age was 55 +/- 7 years. In all patients,
50-80% of the body surface area was affected (Figure 1A). A prominent
eosinophilia (median: 940/mm3; range 400-6000) was
present in all patients. Seven patients were treated with topical
glucocorticoids (class III-IV), two with systemic glucocorticoids
(methylprednisolone, 60mg). All patients recovered from the MDR after a
median time of 13 days (range: 5-18). Patients had a median
sepsis-related organ failure assessment score of 4 (range 2-11). Eleven
patients suffered from acute respiratory distress. The median time
between COVID-19 diagnosis (based on a positive nasopharyngeal
SARS-CoV-2 PCR) and MDR was 25 days (range: 14-42 days).