The effect of dexamethasone in the treatment of high-risk covid19 patients

INTERVENTION: Intervention group: After obtaining informed consent and a full explanation of the treatment steps to the patient and accompanying regarding the treatment process, In addition to receiving the Ministry of Health's treatment protocol, dexamethasone is treated daily 0/1mg/kg for a week.. CONDITION: COVID19. ; COVID‐19, virus identified U07.1 PRIMARY OUTCOME: Initial outcome (mortality rate or Recovery within 30 days after hospitalization). Timepoint: the experiment of RT‐PCR In the lower respiratory tracts When entering the study and One week after treatment Repeat every week too Negative sample twice. Method of measurement: Examining and filling out checklists and performing RT‐PCR tests. SECONDARY OUTCOME: Days without organ support (eg, supplemental O2, mechanical ventilation, dialysis and vasopressors): 28 days 2‐ RT‐PCR examination At the time of admission to the study and one week after treatment and every week to negative sample Twice.3‐Body failure assessment scores 4‐staying time in ICU A period of one year after discharge. 5 The duration of hospital stay ‐ the period of one year after discharge6‐Mechanical ventilation duration ‐ one year after discharge.7‐Chest radiographic findings Time interval: first and 28 days later.8‐Number of patients with side effects from treatment over a period of 28 days Such as diabetes, hypothyroidism, hyperlipidemia, hypertension, cataracts, glaucoma, cushingoid complications and gastrointestinal and skin complications.9‐ ICU mortality ‐ a period of one year after discharge. 10‐Hospital mortality ‐ a period of one year after discharge. Timepoint: The patient will be visited every one to three months of treatment based on the need for treatment and other follow‐ups will be done by phone. Method of measurement: In‐person examination and telephone follow‐up. INCLUSION CRITERIA: Age between 18 and 70 years Laboratory confirmation of Covid19 infection with reverse transcription polymerase chain reaction (RT‐PCR) from any diagnostic sampling source The new organ dysfunction, which is related to Covid19, includes: Hypoxia requires supplemental oxygen to maintain oxygen saturation> 90%. hypotension (systolic blood pressure <90 mmHg) or need for vasopressor / inotropic drug.Renal impairment (especially creatinine) 50% of baseline, onset, received based on glomerular filtration film. Reduce the scale of Glasgow 2 or more, Thrombocytopenia (<150,000 platelets per millimeter). Symptoms of gastrointestinal upset requiring hospitalization (eg, severe nausea, vomiting, diarrhea, or abdominal pain