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).