Efficacy and safety of deflazacort in diabetic subjects infected with SARS-CoV-2

Claudio Ucciferri; Alessandro Di Gasbarro; Jacopo Vecchiet; Katia Falasca

doi:10.5826/mrm.2025.1035

Efficacy and safety of deflazacort in diabetic subjects infected with SARS-CoV-2

Authors

Claudio Ucciferri Clinic of Infectious Diseases – Department of Medicine and Science of Aging, “G. d’Annunzio” University Chieti-Pescara– Italy
Alessandro Di Gasbarro Clinic of Infectious Diseases – Department of Medicine and Science of Aging, “G. d’Annunzio” University Chieti-Pescara– Italy
Jacopo Vecchiet Clinic of Infectious Diseases – Department of Medicine and Science of Aging, “G. d’Annunzio” University Chieti-Pescara– Italy
Katia Falasca Clinic of Infectious Diseases – Department of Medicine and Science of Aging, “G. d’Annunzio” University Chieti-Pescara– Italy

DOI: https://doi.org/10.5826/mrm.2025.1035

Keywords:

COVID-19; CORTICOSTEROIDS; DIABETES MELLITUS; OUTPATIENTS

Abstract

Background: Different therapies are recommended for the management of COVID-19 at home, use of steroids is the reference for the home management of COVID-19 in second phase of the disease. Several steroids are recommended in the treatment of COVID-19; however, the use of steroids is known to bring to problems in the management of diabetic patients.
Methods: This is a retrospective observational study, conducted with the aim of evaluating the efficacy and safety of the administration of deflazacort in diabetic outpatients infected with SARS-CoV-2, versus standard use of dexamethasone/methylprednisolone.
Results: A total of 63 patients were enrolled: 15 in the “deflazacort” group and 48 in the “ dexamethasone/methylprednisolone “ group. The study population was 49.2% male with a median age of 63.6 years (IQR 54.5-71.0). 44 (69.8%) patients had at least one comorbidity in addition to diabetes. A total of 4 (6.3%) patients (50% females) required hospital care for glycaemic decompensation, all in the dexamethasone/methylprednisolone group (0 vs 4 p=0.019). Hospitalization occurred in 19 (30.1%) for respiratory failure related to SARS-CoV-2 infection: 5 in the deflazacort group, 14 in the dexamethasone/methylprednisolone group (p=0.76) The mean number of days between illness onset and the first negative swab was 28.4 days in the deflazacort group and
27.4 days in the dexamethasone/methylprednisolone group (p=0.40).
Conclusion: Deflazacort demonstrated a lower incidence of hospital admission for glycaemic decompensation compared to standard treatment with dexamethasone/methylprednisolone in SARS-CoV-2 positive outpatients. There were no differences in COVID-19-related hospitalizations between the two groups.

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