Effectiveness of glucocorticoids in patients hospitalized for severe SARS-CoV-2 pneumonia.

Autor: Pascual Pareja JF; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., García-Caballero R; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Soler Rangel L; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., Vázquez-Ronda MA; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., Roa Franco S; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Navarro Jiménez G; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Moreno Palanco MA; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., González-Ruano P; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., López-Menchaca R; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Ruíz-Seco P; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., Pagán Muñoz B; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Gómez Gómez A; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Pérez-Monte B; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Fuerte Martínez R; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Valle López JL; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Muñoz Blanco A; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Rábago Lorite I; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Martínez Martín P; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Serralta San Martín G; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain., Gómez-Cerezo JF; Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, Spain.
Jazyk: angličtina
Zdroj: Medicina clinica (English ed.) [Med Clin (Engl Ed)] 2021 Mar 12; Vol. 156 (5), pp. 221-228. Date of Electronic Publication: 2021 Feb 06.
DOI: 10.1016/j.medcle.2020.11.006
Abstrakt: Background: Several studies have reported the beneficial effect of glucocorticoids in the treatment of cytokine storm that occurs in patients with severe COVID-19. Various glucocorticoids regimens have been proposed.
Methods: Retrospective observational study that includes patients with severe SARS-CoV-2 pneumonia and compares admission to an Intensive Care Unit (ICU) or death during hospitalization in three groups of patients: no glucocorticoids treatment, use of glucocorticoids doses equivalent to less than 250 mg of prednisone daily and use of equivalent doses greater than or equal to 250 mg of prednisone daily. Multivariate analysis was performed using logistic regression, using the propensity index as a covariant.
Results: Of the 259 patients enrolled in the study, 67 (25.9%) had an unfavorable evolution, dying or requiring ICU admission. Comparative analyzes between different glucocorticoids treatments and the association with ICU admission or death were: glucocorticoids treatment (any dose) versus no glucocorticoids treatment (OR: 0.71 [0.30-1.66]), treatment with glucocorticoids (≥250 mg prednisone daily) versus no glucocorticoids treatment (OR: 0.35 [0.11-1.08]) and glucocorticoids treatment (≥250 mg prednisone daily) versus patients with glucocorticoids doses <250 mg prednisone daily or without glucocorticoids treatment (OR: 0.30 [0.10-0.88]).
Conclusion: The results of this study show that patients with severe SARS-CoV-2 pneumonia treated with glucocorticoids pulses with equivalent doses of prednisone greater than or equal to 250 mg have a more favorable evolution (less mortality and less admission to ICU).
(© 2020 Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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