Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19

被引：30

作者：

Felipe Reyes, Luis ^{[1
,2
]}

Rodriguez, Alejandro ^{[3
]}

Bastidas, Alirio ^{[1
]}

Parra-Tanoux, Daniela ^{[1
]}

Fuentes, Yuli, V ^{[1
,2
]}

Garcia-Gallo, Esteban ^{[1
]}

Moreno, Gerard ^{[3
]}

Ospina-Tascon, Gustavo ^{[4
,18
]}

Hernandez, Gleen ^{[5
]}

Silva, Edwin ^{[6
]}

Diaz, Ana Maria ^{[7
]}

Jibaja, Manuel ^{[7
]}

Vera-Alarcon, Magdalena ^{[5
]}

Diaz, Emilio ^{[8
]}

Bodi, Maria ^{[3
]}

Sole-Violan, Jordi ^{[9
]}

Ferrer, Ricard ^{[10
]}

Albaya-Moreno, Antonio ^{[11
]}

Socias, Lorenzo ^{[12
]}

Estella, Angel ^{[13
]}

Loza-Vazquez, Ana ^{[14
]}

Jorge-Garcia, Ruth ^{[15
]}

Sancho, Isabel ^{[16
]}

Martin-Loeches, Ignacio ^{[17
]}

机构：

[1] Univ Sabana, Campus Puente Comun,KM 7-5 Autopista Norte Bogota, Chia, Colombia

[2] Clin Univ Sabana, Chia, Colombia

[3] ICU Hosp Univ Joan XXIII IISPV URV, CIBERes, Tarragona, Spain

[4] Fdn Valle Lili, Dept Intens Care, Cali, Colombia

[5] Pontificia Univ Catolica Chile, Dept Med Intens, Santiago, Chile

[6] Fdn Clin Shaio, Bogota, Colombia

[7] Eugenio Espejo Hosp Specialties, Quito, Pichincha, Ecuador

[8] Parc Tauli Univ Hosp, UAB, CIBERES, Barcelona, Spain

[9] Hosp Univ Gran Canaria Dr Negrin, Las Palmas Gran Canaria, Spain

[10] Vall dHebron Hosp Univ, Barcelona, Spain

[11] Guadalajara Univ Hosp, Guadalajara, Spain

[12] Son Llatzer Univ Hosp, Palma De Mallorca, Spain

[13] Jerez Univ Hosp, Jerez de la Frontera, Spain

[14] Hosp Univ Valme Sevilla, Andalucia, Spain

[15] Hosp Providencial Nuestra Senora Gracia, Zaragoza, Spain

[16] Hosp Politecn & Univ La Fe Valencia, Comunidad Valenciana, Spain

[17] St James Hosp, Dept Intens Care Med, Multidisciplinary Intens Care Res Org MICRO, Dublin 8, Ireland

[18] Univ Icesi, TransLab CCM, Cali, Colombia

来源：

JOURNAL OF CRITICAL CARE | 2022年 / 69卷

关键词：

Dexamethasone; COVID-19; Critical care; Severe COVID-19; Pneumonia; VENTILATOR-ASSOCIATED PNEUMONIA; HOSPITALIZED-PATIENTS; PREVALENCE;

D O I：

10.1016/j.jcrc.2022.154014

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, es-pecially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. Methods: This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation be-tween dexamethasone treatment and ICU-RTI. Results: A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p < 0.001).

引用

页数：8

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