Clinical observation of glucocorticoid therapy for critically ill patients with COVID-19 pneumonia

被引:2
作者
Zhu, Yingjie [1 ]
Chen, Dongmei [1 ]
Zhu, Yanfang [2 ]
Ge, Xuhua [1 ]
Li, Zhuo [1 ]
Miao, Hongjun [1 ,3 ]
机构
[1] Nanjing Med Univ, Childrens Hosp, Dept Emergency Crit Care Med, 72 Guangzhou Rd, Nanjing, Peoples R China
[2] Huangshi Hosp TCM, Infect Dis Hosp, Dept Crit Care Med, 12 Guangchang Rd, Huangshi, Peoples R China
[3] Nanjing Med Univ, Childrens Hosp, 72 Guangzhou Rd, Nanjing 210008, Peoples R China
关键词
Glucocorticoid; COVID-19; pneumonia; clinical effect; survival; severity; ACUTE RESPIRATORY SYNDROME; SARS; CORTICOSTEROIDS; MORTALITY; ADULTS;
D O I
10.1177/03000605221149292
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
ObjectiveWe aimed to investigate the clinical effects of intravenous glucocorticoid (GC) therapy for severe COVID-19 pneumonia. MethodsSeventy-two patients hospitalized with severe COVID-19 pneumonia who were discharged or died between 5 January 2020 and 3 March 2020 at Huangshi Infectious Disease Hospital were included. Patients were divided into a treatment group (GC group) and non-treatment group (non-GC group) according to whether they had received GCs within 7 days of hospital admission. ResultsThere was no significant difference between groups for Acute Physiology and Chronic Health Evaluation (APACHE) II score and 28-day survival rate. The rate of invasive mechanical ventilation was higher in the GC group than in the non-GC group. On day 7 after admission, the GC group had shorter fever duration and higher white blood cell count than the non-GC group. In subgroup analysis by age and severity, there was no significant difference in 28-day survival rate and other indicators. Compared with those in the non-GC group, patients in the GC group more frequently required admission to the intensive care unit. ConclusionIn the present study, we found no significant improvement in patients with severe COVID-19 pneumonia treated with GCs within 7 days of admission.
引用
收藏
页数:10
相关论文
共 27 条
[1]   Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome [J].
Arabi, Yaseen M. ;
Mandourah, Yasser ;
Al-Hameed, Fahad ;
Sindi, Anees A. ;
Almekhlafi, Ghaleb A. ;
Hussein, Mohamed A. ;
Jose, Jesna ;
Pinto, Ruxandra ;
Al-Omari, Awad ;
Kharaba, Ayman ;
Almotairi, Abdullah ;
Al Khatib, Kasim ;
Alraddadi, Basem ;
Shalhoub, Sarah ;
Abdulmomen, Ahmed ;
Qushmaq, Ismael ;
Mady, Ahmed ;
Solaiman, Othman ;
Al-Aithan, Abdulsalam M. ;
Al-Raddadi, Rajaa ;
Ragab, Ahmed ;
Balkhy, Hanan H. ;
Al Harthy, Abdulrahman ;
Deeb, Ahmad M. ;
Al Mutairi, Hanan ;
Al-Dawood, Abdulaziz ;
Merson, Laura ;
Hayden, Frederick G. ;
Fowler, Robert A. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2018, 197 (06) :757-767
[2]   The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study [J].
Auyeung, TW ;
Lee, JSW ;
Lai, WK ;
Choi, CH ;
Lee, HK ;
Lee, JS ;
Li, PC ;
Lok, KH ;
Ng, YY ;
Wong, WM ;
Yeung, YM .
JOURNAL OF INFECTION, 2005, 51 (02) :98-102
[3]   Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? [J].
Batlle, Daniel ;
Wysocki, Jan ;
Satchell, Karla .
CLINICAL SCIENCE, 2020, 134 (05) :543-545
[4]   Early Corticosteroids in Severe Influenza A/H1N1 Pneumonia and Acute Respiratory Distress Syndrome [J].
Brun-Buisson, Christian ;
Richard, Jean-Christophe M. ;
Mercat, Alain ;
Thiebaut, Anne C. M. ;
Brochard, Laurent .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (09) :1200-1206
[5]  
Cao B, 2020, NEW ENGL J MED, V382, P1787, DOI [10.1056/NEJMoa2001282, 10.1056/NEJMc2008043]
[6]   Clinical Features and Short-term Outcomes of 102 Patients with Coronavirus Disease 2019 in Wuhan, China [J].
Cao, Jianlei ;
Tu, Wen-Jun ;
Cheng, Wenlin ;
Yu, Lei ;
Liu, Ya-Kun ;
Hu, Xiaoyong ;
Liu, Qiang .
CLINICAL INFECTIOUS DISEASES, 2020, 71 (15) :748-755
[7]   Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology [J].
Channappanavar, Rudragouda ;
Perlman, Stanley .
SEMINARS IN IMMUNOPATHOLOGY, 2017, 39 (05) :529-539
[8]   Treatment of severe acute respiratory syndrome with glucosteroids - The Guangzhou experience [J].
Chen, Rong-chang ;
Tang, Xiao-ping ;
Tan, Shou-yong ;
Liang, Bi-ling ;
Wan, Zhuo-yue ;
Fang, Ji-qian ;
Zhong, Nanshan .
CHEST, 2006, 129 (06) :1441-1452
[9]   Glucocorticoid administration accelerates mortality of pneumovirus-infected mice [J].
Domachowske, JB ;
Bonville, CA ;
Ali-Ahmad, D ;
Dyer, KD ;
Easton, AJ ;
Rosenberg, HF .
JOURNAL OF INFECTIOUS DISEASES, 2001, 184 (12) :1518-1523
[10]   Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19 [J].
Gao, Yong ;
Li, Tuantuan ;
Han, Mingfeng ;
Li, Xiuyong ;
Wu, Dong ;
Xu, Yuanhong ;
Zhu, Yulin ;
Liu, Yan ;
Wang, Xiaowu ;
Wang, Linding .
JOURNAL OF MEDICAL VIROLOGY, 2020, 92 (07) :791-796