{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T20:30:32Z","timestamp":1772656232249,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Mol. Biosci."],"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> This study aimed to describe the effects of low-dose (prednisolone acetate 2.5\u20137.5\u00a0mg\/day) glucocorticoids (GCs) maintenance therapy in patients with primary nephrotic syndrome (NS) suffering from coronavirus disease 2019 (COVID-19).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A single-center retrospective study of NS patients with COVID-19 infection in Zhongda Hospital Affiliated to Southeast University from 1 February 2022 to 31 March 2023 was conducted. All enrolled patients underwent renal biopsy for the pathological diagnosis and reached complete remission (CR) or near-CR before COVID-19 infection. According to the maintained therapy regimen, patients were divided into low-dose GCs group and non-GCs group.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 125 patients were enrolled in the study. Their median age was 46.0 \u00b1 15.6\u00a0years, and the median value of 24-h urine protein was 0.77\u00a0g. The majority of these patients received treatment for more than 6\u00a0months, with a significant portion achieving CR (29.6%) or near-CR (43.2%). The leading cause of NS was membranous nephropathy (52%). There were no significant differences in the baseline characteristics between low-dose GCs and non-GCs group. As compared to those in the non-GCs group, patients receiving low-dose GCs treatment showed less fatigue or muscle weakness, smell disorder, palpitations, decreased appetite, taste disorder, dizziness, sore throat or difficult to swallow and fever (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Moreover, patients in the low-dose GCs group were with higher median quality of life scores (85.0) than in the non-GCs group (<jats:italic>p<\/jats:italic> = 0.001). Further serum inflammatory factor analysis indicated that interleukin-6 (IL-6) levels in the non-GCs group were significantly higher than that in the low-dose GCs group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Patients with NS in low-dose GCs maintenance therapy stage showed milder symptom, higher quality of life and decreased serum IL-6 levels compared to those, who were not on GCs maintenance therapy. These results suggest the beneficial effect of low-dose GCs therapy in NS patients with CR\/near-CR suffering from COVID-19 infection.<\/jats:p>","DOI":"10.3389\/fmolb.2023.1326111","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T04:34:15Z","timestamp":1704947655000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The analysis of low-dose glucocorticoid maintenance therapy in patients with primary nephrotic syndrome suffering from COVID-19"],"prefix":"10.3389","volume":"10","author":[{"given":"Yong-Qi","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Jia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Xia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Nan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo-Fan","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Qing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ri-Ning","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bi-Cheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"20420188211072704","DOI":"10.1177\/20420188211072704","article-title":"Real-world evidence of the use of glucocorticoids for severe COVID-19","volume":"13","author":"Albarr\u00e1n-S\u00e1nchez","year":"2022","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"B2","doi-asserted-by":"publisher","first-page":"649128","DOI":"10.3389\/fnut.2021.649128","article-title":"The looming effects of estrogen in covid-19: a rocky rollout","volume":"8","author":"Al-Kuraishy","year":"2021","journal-title":"Front. Nutr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1001\/jama.2020.17022","article-title":"Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19: the REMAP-CAP COVID-19 corticosteroid domain randomized clinical trial","volume":"324","author":"Angus","year":"2020","journal-title":"JAMA"},{"key":"B4","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/TP.0000000000003502","article-title":"Early changes in kidney transplant immunosuppression regimens during the COVID-19 pandemic","volume":"105","author":"Bae","year":"2021","journal-title":"Transplantation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00134-021-06394-2","article-title":"Corticosteroids in COVID-19 and non-COVID-19 ARDS: a systematic review and meta-analysis","volume":"47","author":"Chaudhuri","year":"2021","journal-title":"Intensive Care Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1681\/ASN.2019050546","article-title":"Comparison of the efficacy and safety of tacrolimus and low-dose corticosteroid with high-dose corticosteroid for minimal change nephrotic syndrome in adults","volume":"32","author":"Chin","year":"2021","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1001\/jama.2020.16761","article-title":"Effect of hydrocortisone on 21-day mortality or respiratory support among critically ill patients with COVID-19: a randomized clinical trial","volume":"324","author":"Dequin","year":"2020","journal-title":"JAMA"},{"key":"B8","volume-title":"Diagnosis and treatment protocol for novel coronavirus infection (Trial version 10)","year":"2023"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1007\/s10787-022-00987-z","article-title":"COVID-19 and corticosteroids: a narrative review","volume":"30","author":"El-Saber Batiha","year":"2022","journal-title":"Inflammopharmacology"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.3389\/fimmu.2019.01859","article-title":"Fighting the fire: mechanisms of inflammatory gene regulation by the glucocorticoid receptor","volume":"10","author":"Escoter-Torres","year":"2019","journal-title":"Front. Immunol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"27","DOI":"10.2302\/kjm.2020-0007-LE","article-title":"COVID-19: stay cool toward corticosteroids","volume":"69","author":"Fujishima","year":"2020","journal-title":"Keio J. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1080\/22221751.2020.1770129","article-title":"Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors","volume":"9","author":"Han","year":"2020","journal-title":"Emerg. Microbes Infect."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res. Int. J. Qual. Life Asp. Treat. Care Rehabil."},{"key":"B14","doi-asserted-by":"publisher","first-page":"110529","DOI":"10.1016\/j.biopha.2020.110529","article-title":"Clinical efficacy of glucocorticoid on the treatment of patients with COVID-19 pneumonia: a single-center experience","volume":"130","author":"Hu","year":"2020","journal-title":"Biomed. Pharmacother. Biomedecine Pharmacother."},{"key":"B15","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet Lond Engl."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1681\/ASN.2007020166","article-title":"A randomized, controlled trial of steroids and cyclophosphamide in adults with nephrotic syndrome caused by idiopathic membranous nephropathy","volume":"18","author":"Jha","year":"2007","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"B17","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/ckj\/sfz061","article-title":"The safety and efficacy of mycophenolate mofetil in children and adolescents with steroid-dependent nephrotic syndrome: a single-centre study","volume":"13","author":"Karunamoorthy","year":"2020","journal-title":"Clin. Kidney J."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1080\/0886022X.2022.2143377","article-title":"The quantifying relationship between the remission duration and the cardiovascular and kidney outcomes in the patients with primary nephrotic syndrome","volume":"44","author":"Lai","year":"2022","journal-title":"Ren. Fail"},{"key":"B19","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s40121-020-00332-3","article-title":"Efficacy evaluation of early, low-dose, short-term corticosteroids in adults hospitalized with non-severe COVID-19 pneumonia: a retrospective cohort study","volume":"9","author":"Li","year":"2020","journal-title":"Infect. Dis. Ther."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1093\/cid\/ciaa829","article-title":"High-dose but not low-dose corticosteroids potentially delay viral shedding of patients with COVID-19","volume":"72","author":"Li","year":"2021","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"B21","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1378\/chest.93.3.580","article-title":"Evaluation of clinical methods for rating dyspnea","volume":"93","author":"Mahler","year":"1988","journal-title":"Chest"},{"key":"B22","doi-asserted-by":"publisher","first-page":"815","DOI":"10.2215\/CJN.12991117","article-title":"Glucocorticoids in the treatment of glomerular diseases: pitfalls and pearls","volume":"13","author":"Ponticelli","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"B23","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1080\/1744666X.2021.1919086","article-title":"The role of IL-6 and IL-6 blockade in COVID-19","volume":"17","author":"Potere","year":"2021","journal-title":"Expert Rev. Clin. Immunol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-5D: a measure of health status from the EuroQol Group","volume":"33","author":"Rabin","year":"2001","journal-title":"Ann. Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2652","DOI":"10.1681\/ASN.2021040561","article-title":"Human or chimeric monoclonal anti-CD20 antibodies for children with nephrotic syndrome: a superiority randomized trial","volume":"32","author":"Ravani","year":"2021","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2921","DOI":"10.3390\/cells10112921","article-title":"The role of glucocorticoids in inflammatory diseases","volume":"10","author":"Reichardt","year":"2021","journal-title":"Cells"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e160251","DOI":"10.1172\/jci.insight.160251","article-title":"Glucocorticoids target the CXCL9\/CXCL10-CXCR3 axis and confer protection against immune-mediated kidney injury","volume":"8","author":"Riedel","year":"2023","journal-title":"JCI Insight"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1681\/ASN.2012020181","article-title":"Rituximab in idiopathic membranous nephropathy","volume":"23","author":"Ruggenenti","year":"2012","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"B29","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s00467-018-3929-z","article-title":"Pharmacology and pharmacogenetics of prednisone and prednisolone in patients with nephrotic syndrome","volume":"34","author":"Schijvens","year":"2019","journal-title":"Pediatr. Nephrol. Berl. Ger."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1001\/jama.2020.17021","article-title":"Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: the CoDEX randomized clinical trial","volume":"324","author":"Tomazini","year":"2020","journal-title":"JAMA"},{"key":"B31","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.tem.2017.10.010","article-title":"Therapeutic mechanisms of glucocorticoids","volume":"29","author":"Vandewalle","year":"2018","journal-title":"Trends Endocrinol. Metab. Tem."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e0111","DOI":"10.1097\/CCE.0000000000000111","article-title":"Rationale for prolonged corticosteroid treatment in the acute respiratory distress syndrome caused by coronavirus disease 2019","volume":"2","author":"Villar","year":"2020","journal-title":"Crit. Care Explor"},{"key":"B33","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"B34","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1080\/22221751.2021.1885998","article-title":"Beneficial effect of combinational methylprednisolone and remdesivir in hamster model of SARS-CoV-2 infection","volume":"10","author":"Ye","year":"2021","journal-title":"Emerg. Microbes Infect."}],"container-title":["Frontiers in Molecular Biosciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmolb.2023.1326111\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T04:34:18Z","timestamp":1704947658000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmolb.2023.1326111\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,11]]},"references-count":35,"alternative-id":["10.3389\/fmolb.2023.1326111"],"URL":"https:\/\/doi.org\/10.3389\/fmolb.2023.1326111","relation":{},"ISSN":["2296-889X"],"issn-type":[{"value":"2296-889X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,11]]},"article-number":"1326111"}}