Corticosteroid therapy is associated with the delay of SARS-CoV-2 clearance in COVID-19 patients

被引：30

作者：

Huang, Rui ^{[1
]}

Zhu, Chuanwu ^{[2
]}

Wang, Jian ^{[1
]}

Xue, Leyang ^{[3
]}

Li, Chunyang ^{[4
]}

Yan, Xiaomin ^{[1
]}

Huang, Songping ^{[5
]}

Zhang, Biao ^{[6
]}

Zhu, Li ^{[2
]}

Xu, Tianmin ^{[7
]}

Ming, Fang ^{[5
]}

Zhao, Yun ^{[8
]}

Cheng, Juan ^{[9
]}

Shao, Huaping ^{[10
]}

Zhao, Xiang-An ^{[11
]}

Sang, Dawen ^{[9
]}

Zhao, Haiyan ^{[10
]}

Guan, Xinying ^{[12
]}

Chen, Xiaobing ^{[13
]}

Chen, Yuxin ^{[14
]}

Wei, Jie ^{[15
]}

Issa, Rahma ^{[15
]}

Liu, Longgen ^{[7
]}

Yan, Xuebing ^{[4
]}

Wu, Chao ^{[1
]}

机构：

[1] Nanjing Univ, Affiliated Hosp, Dept Infect Dis, Nanjing Drum Tower Hosp,Med Sch, 321 Zhongshan Rd, Nanjing 210008, Peoples R China

[2] Soochow Univ, Affiliated Infect Dis Hosp, Dept Infect Dis, Suzhou, Peoples R China

[3] Huaian 4 Peoples Hosp, Dept Crit Med, Huaian, Peoples R China

[4] Xuzhou Med Univ, Affiliated Hosp, Dept Infect Dis, 9 Kunpeng Rd, Xuzhou 221000, Jiangsu, Peoples R China

[5] Nantong Univ, Nantong Peoples Hosp 3, Dept Infect Dis, Nantong, Peoples R China

[6] Huaian 4 Peoples Hosp, Dept Qual Control Off, Huaian, Peoples R China

[7] Third Peoples Hosp Changzhou, Dept Infect Dis, 300 Lanling Rd, Changzhou 213001, Jiangsu, Peoples R China

[8] Third Peoples Hosp Yangzhou, Dept Infect Dis, Yangzhou, Jiangsu, Peoples R China

[9] Yancheng Second Peoples Hosp, Dept Infect Dis, Yancheng, Peoples R China

[10] Peoples Hosp Suqian, Dept Infect Dis, Suqian, Peoples R China

[11] Yangzhou Univ, Clin Med Coll, Northern Jiangsu Peoples Hosp, Dept Gastroenterol, Yangzhou, Jiangsu, Peoples R China

[12] Nanjing Med Univ, Peoples Hosp Lianyungang 1, Affiliated Hosp Kangda Coll, Dept Neurol, Lianyungang, Peoples R China

[13] Nanjing Med Univ, Peoples Hosp Lianyungang 1, Affiliated Hosp, Dept Emergency,Kangda Coll, Lianyungang, Peoples R China

[14] Nanjing Univ, Nanjing Drum Tower Hosp, Dept Lab Med, Affiliated Hosp,Med Sch, Nanjing, Peoples R China

[15] Nanjing Med Univ, Nanjing Drum Tower Hosp, Dept Infect Dis, Clin Coll, Nanjing, Peoples R China

来源：

EUROPEAN JOURNAL OF PHARMACOLOGY | 2020年 / 889卷

关键词：

Coronavirus disease 2019; Virus clearance; Corticosteroid; CLINICAL CHARACTERISTICS; CYTOKINE STORM; SARS;

D O I：

10.1016/j.ejphar.2020.173556

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

The impact of corticosteroid treatment on virological course of coronavirus disease 2019 (COVID-19) patients remains unclear. This study aimed to explore the association between corticosteroid and viral clearance in COVID-19. The clinical data of COVID-19 patients from 10 hospitals of Jiangsu, China, were retrospectively collected. Cox regression and Kaplan-Meier analysis were used to analyze the adverse factors of virus clearance. Of the 309 COVID-19 patients, eighty-nine (28.8%) patients received corticosteroid treatment during hospitalization. Corticosteroid group showed higher C-reactive protein (median 11.1 vs. 7.0 mg/l, P = 0.018) and lower lymphocytes (median 0.9 vs. 1.4 x 10(9)/l, P < 0.001) on admission. Fever (93.3% vs. 65.0%, P < 0.001) and cough (69.7% vs. 57.3%, P = 0.043) were more common in corticosteroid group. The proportions of patients with severe illness (34.8% vs. 1.8%, P < 0.001), respiratory failure (25.8% vs. 1.4%, P < 0.001), acute respiratory distress syndrome (4.5% vs. 0%, P = 0.002), and admission to ICU (20.2% vs. 0.9%, P < 0.001) were significantly higher in corticosteroid group than non-corticosteroid group. The duration of virus clearance (median 18.0 vs. 16.0 days, P < 0.001) and hospitalization (median 17.0 vs. 15.0 days, P < 0.001) were also significantly longer in corticosteroid group than non-corticosteroid group. Treated with corticosteroid (Hazard ratio [HR], 0.698; 95% confidence interval [CI], 0.512 to 0.951; P = 0.023) was an adverse factor of the clearance of SARS-CoV-2, especially for male patients (HR, 0.620; 95% CI, 0.408 to 0.942; P = 0.025). The cumulative probability of SARS-CoV-2 clearance was lower in corticosteroid group (P < 0.001). Corticosteroid treatment may delay the SARS-CoV-2 clearance of COVID-19 patients and should be used with cautions.

引用

页数：5

共 22 条

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