1. Viral clearance after early corticosteroid treatment in patients with moderate or severe covid-19
- Author
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Spagnuolo, V., Guffanti, M., Galli, L., Poli, A., Querini, P. Rovere, Ripa, M., Clementi, M., Scarpellini, P., Lazzarin, A., Tresoldi, Moreno, Dagna, L., Zangrillo, A., Ciceri, F., Castagna, A., Andolina, A., Redaelli, M. Baiardo, Baldissera, E., Bigai, G., Bigoloni, A., Boffini, N., Borio, G., Bossolasco, S., Bruzzesi, E., Calabrò, M. G., Calvisi, S., Campochiaro, C., Canetti, D., Canti, V., Castellani, J., Castiglioni, B., Cavalli, G., Cavallo, L., Cernuschi, M., Chiurlo, M., Cilla, M., Cinel, E., Cinque, P., Conte, C., Da Prat, V., Danise, A., De Lorenzo, R., De Luca, G., Dell’Acqua, A., Dell’Acqua, R., Torre, E. Della, Torre, L. Della, Di Terlizzi, G., Dumea, I., Farolfi, F., Ferrante, M., Frangi, C., Fumagalli, L., Gallina, G., Germinario, B., Gianotti, Nicola, Hasson, H., Lalla, F., LANDONI, Giovanni, Lanzillotta, M., Voti, R. Li, Mastrangelo, A., Messina, E., Moizo, E., Montagna, M., Monti, G., Morsica, G., Muccini, C., Nozza, S., Oltolini, C., Pascali, M., Patrizi, A., Pieri, M., Prestifilippo, D., Ramirez, Giuseppe Alvise, Ranzenigo, M., Sapienza, J., Sartorelli, S., Seghi, F., Tambussi, G., Din, C. Tassan, Tomelleri, A., Turi, S., Uberti-Foppa, C., Vinci, C., COVID-BioB study group, Spagnuolo, V., Guffanti, M., Galli, L., Poli, A., Querini, P. R., Ripa, M., Clementi, M., Scarpellini, P., Lazzarin, A., Tresoldi, M., Dagna, L., Zangrillo, A., Ciceri, F., Castagna, A., Andolina, A., Redaelli, M. B., Baldissera, E., Bigai, G., Bigoloni, A., Boffini, N., Borio, G., Bossolasco, S., Bruzzesi, E., Calabro, M. G., Calvisi, S., Campochiaro, C., Canetti, D., Canti, V., Castellani, J., Castiglioni, B., Cavalli, G., Cavallo, L., Cernuschi, M., Chiurlo, M., Cilla, M., Cinel, E., Cinque, P., Conte, C., Da Prat, V., Danise, A., De Lorenzo, R., De Luca, G., Dell'Acqua, A., Dell'Acqua, R., Torre, E. D., Torre, L. D., Di Terlizzi, G., Dumea, I., Farolfi, F., Ferrante, M., Frangi, C., Fumagalli, L., Gallina, G., Germinario, B., Gianotti, N., Hasson, H., Lalla, F., Landoni, G., Lanzillotta, M., Voti, R. L., Mastrangelo, A., Messina, E., Moizo, E., Montagna, M., Monti, G., Morsica, G., Muccini, C., Nozza, S., Oltolini, C., Pascali, M., Patrizi, A., Pieri, M., Prestifilippo, D., Ramirez, G., Ranzenigo, M., Sapienza, J., Sartorelli, S., Seghi, F., Tambussi, G., Din, C. T., Tomelleri, A., Turi, S., Uberti-Foppa, C., and Vinci, C.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Coronavirus disease 2019 (COVID-19) ,Lymphocyte ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Corticosteroid treatment ,Severe disease ,Diseases ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Pandemics ,Aged ,Retrospective Studies ,Multidisciplinary ,business.industry ,Proportional hazards model ,Age Factors ,COVID-19 ,Retrospective cohort study ,Middle Aged ,Viral Load ,Publisher Correction ,COVID-19 Drug Treatment ,Hospitalization ,Treatment Outcome ,Infectious diseases ,Viral infection ,medicine.anatomical_structure ,Italy ,Female ,business - Abstract
The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO2/FiO2 ≤ 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or ≤ 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p 2/FiO2 > 200 mmHg, and a lymphocyte count at admission > 1.0 × 109/L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.
- Published
- 2020
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