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Role of the early short-course corticosteroids treatment in ARDS caused by COVID-19: A single-center, retrospective analysis.
- Source :
-
Advances in medical sciences [Adv Med Sci] 2021 Sep; Vol. 66 (2), pp. 262-268. Date of Electronic Publication: 2021 Apr 24. - Publication Year :
- 2021
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Abstract
- Purpose: Severe coronavirus disease 2019 (COVID-19) is strongly related to interstitial pneumonia with frequent development of acute respiratory distress syndrome (ARDS). The role of corticosteroids (CS) treatment in these patients is still controversial. Some studies evidenced a possible role of an early short-term course of CS treatment in the treatment of severe pneumonia.<br />Patients and Methods: This is a single-center, retrospective study considering the patients with confirmed COVID-19 pneumonia admitted to our hospital between 9th March and 15 <superscript>th</superscript> June 2020. Two groups were considered: early high-dose of methyl-prednisolone (eHDM; n = 31) and the control group (n = 52). Patients in the eHDM group received the dose of 5-8 mg/kg/day of methyl-prednisolone for 2 consecutive days. Primary outcome was the mortality evaluation; secondary outcomes were clinical improvement, side-effects and laboratory/radiographic changes.<br />Results: Significant differences between the two groups were: length of hospitalization (21.5 vs 28.4 days, p = 0.026), length of non-invasive ventilation (NIV) or mechanical ventilation (11.5 vs 14.5 days, p = 0.031), death (5 vs 12, p = 0.006) and clinical improvement (16 vs 11, p=0.018). The following factors were related to in-hospital mortality in the multivariate analysis: comorbidities (OR = 2.919; 95%CI = 1.515-16.705; p<0.001), days from the onset of symptoms and the hospital admission (OR = 1.404; 95%CI = 1.069-12.492; p = 0.011), PaO <subscript>2</subscript> /FiO <subscript>2</subscript> (P/F) ratio (OR = 3.111; 95%CI = 2.334-16.991; p = 0.009) and eHDM treatment (OR = 0.741; 95%CI = 0.129-0.917; p = 0.007).<br />Conclusion: The eHDM is an interesting and promising approach in the ARDS related to COVID-19 pneumonia, which reduces mortality, length of hospitalization and the need for mechanical ventilation.<br />Competing Interests: Declaration of competing interest The authors declare no conflict of interests.<br /> (Copyright © 2021 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adrenal Cortex Hormones administration & dosage
Aged
Dose-Response Relationship, Drug
Duration of Therapy
Early Medical Intervention methods
Female
Hospital Mortality
Humans
Italy epidemiology
Male
Outcome and Process Assessment, Health Care
Respiration, Artificial statistics & numerical data
Severity of Illness Index
Treatment Outcome
COVID-19 diagnosis
COVID-19 physiopathology
COVID-19 therapy
Lung diagnostic imaging
Methylprednisolone administration & dosage
Pneumonia, Viral diagnosis
Pneumonia, Viral drug therapy
Pneumonia, Viral virology
Respiratory Distress Syndrome diagnosis
Respiratory Distress Syndrome etiology
Respiratory Distress Syndrome therapy
SARS-CoV-2 isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1898-4002
- Volume :
- 66
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Advances in medical sciences
- Publication Type :
- Academic Journal
- Accession number :
- 34022675
- Full Text :
- https://doi.org/10.1016/j.advms.2021.04.002