Effect of Systemic Glucocorticoids on Mortality or Mechanical Ventilation in Patients With COVID-19

被引：94

作者：

Keller, Marla J. ^{[1
,2
]}

Kitsis, Elizabeth A. ^{[2
,3
]}

Arora, Shitij ^{[2
,4
]}

Chen, Jen-Ting ^{[2
,5
]}

Agarwal, Shivani ^{[2
,6
]}

Ross, Michael J. ^{[2
,7
]}

Tomer, Yaron ^{[2
,6
]}

Southern, William ^{[2
,4
]}

机构：

[1] Montefiore Med Ctr, Dept Med, Div Infect Dis, Bronx, NY 10467 USA

[2] Albert Einstein Coll Med, Bronx, NY 10467 USA

[3] Montefiore Med Ctr, Dept Med, Div Rheumatol, Bronx, NY 10467 USA

[4] Montefiore Med Ctr, Dept Med, Div Hosp Med, Bronx, NY 10467 USA

[5] Montefiore Med Ctr, Dept Med, Div Crit Care Med, Bronx, NY 10467 USA

[6] Montefiore Med Ctr, Dept Med, Div Endocrinol, Bronx, NY 10467 USA

[7] Montefiore Med Ctr, Dept Med, Div Nephrol, Bronx, NY 10467 USA

来源：

JOURNAL OF HOSPITAL MEDICINE | 2020年 / 15卷 / 08期

关键词：

CORTICOSTEROID TREATMENT;

D O I：

10.12788/jhm.3497

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The efficacy of glucocorticoids in COVID-19 is unclear. This study was designed to determine whether systemic glucocorticoid treatment in COVID-19 patients is associated with reduced mortality or mechanical ventilation. This observational study included 1,806 hospitalized COVID-19 patients; 140 were treated with glucocorticoids within 48 hours of admission. Early use of glucocorticoids was not associated with mortality or mechanical ventilation. However, glucocorticoid treatment of patients with initial C-reactive protein (CRP) >= 20 mg/dL was associated with significantly reduced risk of mortality or mechanical ventilation (odds ratio, 0.23; 95% CI, 0.08-0.70), while glucocorticoid treatment of patients with CRP <10 mg/dL was associated with significantly increased risk of mortality or mechanical ventilation (OR, 2.64; 95% CI, 1.39-5.03). Whether glucocorticoid treatment is associated with changes in mortality or mechanical ventilation in patients with high or low CRP needs study in prospective, randomized clinical trials. (c) 2020 Society of Hospital Medicine

引用

页码：489 / 493

页数：5

共 35 条

[31] Efficacy of dexamethasone treatment for patients with the acute respiratory distress syndrome caused by COVID-19: study protocol for a randomized controlled superiority trial [J].

Villar, Jesus ;

Anon, Jose M. ;

Ferrando, Carlos ;

Aguilar, Gerardo ;

Munoz, Tomas ;

Ferreres, Jose ;

Ambros, Alfonso ;

Aldecoa, Cesar ;

Suarez-Sipmann, Fernando ;

Thorpe, Kevin E. ;

Juni, Peter ;

Slutsky, Arthur S. .

TRIALS, 2020, 21 (01)

[32] Cyclosporine A plus low-dose steroid treatment in COVID-19 improves clinical outcomes in patients with moderate to severe disease: A pilot study [J].

Galvez-Romero, J. L. ;

Palmeros-Rojas, O. ;

Real-Ramirez, F. A. ;

Sanchez-Romero, S. ;

Tome-Maxil, R. ;

Ramirez-Sandoval, M. P. ;

Olivos-Rodriguez, R. ;

Flores-Encarnacion, S. E. ;

Cabrera-Estrada, A. A. ;

Avila-Morales, J. ;

Cortes-Sanchez, V ;

Sarmiento-Padilla, G. ;

Tezmol-Ramirez, S. E. ;

Aparicio-Hernandez, D. ;

Urbina-Sanchez, M., I ;

Gomez-Pluma, M. A. ;

Cisneros-Mendez, S. ;

Rodriguez-Rivas, D., I ;

Reyes-Inurrigarro, S. ;

Cortes-Diaz, G. ;

Cruz-Delgado, C. ;

Navarro-Gonzalez, J. ;

Deveaux-Homs, J. ;

Pedraza-Sanchez, S. .

JOURNAL OF INTERNAL MEDICINE, 2021, 289 (06) :906-920

[33] Short-Course of Methylprednisolone Improves Respiratory Functional Parameters After 120 Days in Hospitalized COVID-19 Patients (Metcovid Trial): A Randomized Clinical Trial [J].

Barros, Camila Miriam Suemi Sato ;

Freire, Raissa Soares ;

Frota, Elisangela ;

Rezende Santos, Anna Gabriela ;

Farias, Maria Eduarda Leao ;

Rodrigues, Maria Gabriela Almeida ;

Silva, Bernardo Maia ;

Prado Jeronimo, Christiane Maria ;

Netto, Rebeca Linhares Abreu ;

Silva Borba, Mayla Gabriela ;

Baia-da-Silva, Djane ;

Brito-Sousa, Jose Diego ;

Xavier, Mariana Simao ;

Araujo-Alexandre, Marcia Almeida ;

Sampaio, Vanderson Souza ;

Melo, Gisely Cardoso ;

Areas, Guilherme Tinoco ;

Hajjar, Ludhmila Abrahao ;

Monteiro, Wuelton Marcelo ;

Gomes Naveca, Felipe ;

Costa, Fabio Trindade Maranhao ;

Val, Fernando Fonseca Almeida ;

Lacerda, Marcus Vinicius Guimaraes .

FRONTIERS IN MEDICINE, 2021, 8

[34] Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP) [J].

Bassetti, Matteo ;

Giacobbe, Daniele Roberto ;

Bruzzi, Paolo ;

Barisione, Emanuela ;

Centanni, Stefano ;

Castaldo, Nadia ;

Corcione, Silvia ;

De Rosa, Francesco Giuseppe ;

Di Marco, Fabiano ;

Gori, Andrea ;

Gramegna, Andrea ;

Granata, Guido ;

Gratarola, Angelo ;

Maraolo, Alberto Enrico ;

Mikulska, Malgorzata ;

Lombardi, Andrea ;

Pea, Federico ;

Petrosillo, Nicola ;

Radovanovic, Dejan ;

Santus, Pierachille ;

Signori, Alessio ;

Sozio, Emanuela ;

Tagliabue, Elena ;

Tascini, Carlo ;

Vancheri, Carlo ;

Vena, Antonio ;

Viale, Pierluigi ;

Blasi, Francesco .

INFECTIOUS DISEASES AND THERAPY, 2021, 10 (04) :1837-1885

[35] Pragmatic, open-label, single-center, randomized, phase II clinical trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus in patients with severe pneumonia secondary to COVID-19: The TACROVID trial protocol [J].

Solanich, X. ;

Antoli, A. ;

Padulles, N. ;

Fanlo-Maresma, M. ;

Iriarte, A. ;

Mitjavila, F. ;

Capdevila, O. ;

Molina, M. ;

Sabater, J. ;

Bas, J. ;

Mensa-Vilaro, A. ;

Niubo, J. ;

Calvo, N. ;

Bolivar, S. ;

Rigo-Bonnin, R. ;

Arregui, L. ;

Tebe, C. ;

Hereu, P. ;

Videla, S. ;

Corbella, X. .

CONTEMPORARY CLINICAL TRIALS COMMUNICATIONS, 2021, 21

← 1 2 3 4 →