Evolution of the Use of Corticosteroids for the Treatment of Hospitalised COVID-19 Patients in Spain between March and November 2020: SEMI-COVID National Registry.

Autor: Balaz D; Department of Internal Medicine, Hospital Universitario San Juan de Alicante, 03550 Alicante, Spain.; Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, 03202 Alicante, Spain., Wikman-Jorgensen PE; Department of Internal Medicine, Hospital Universitario San Juan de Alicante, 03550 Alicante, Spain.; Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, 03202 Alicante, Spain., Galvañ VG; Department of Internal Medicine, Hospital Universitario San Juan de Alicante, 03550 Alicante, Spain.; Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, 03202 Alicante, Spain.; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Conselleria de Sanitat, 46010 Valencia, Spain., Rubio-Rivas M; Department of Internal Medicine, Hospital Universitario de Bellvitge, 08907 Barcelona, Spain., de Miguel Campo B; Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain., López MN; Department of Internal Medicine, Hospital Costa del Sol, 29603 Málaga, Spain., Caleya JFL; Department of Internal Medicine, Hospital de Cabueñes, 33394 Gijón, Asturias, Spain., Huelgas RG; Department of Internal Medicine, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain., Fontán PMP; Department of Internal Medicine, Hospital Clínico de Santiago de Compostela, 15706 A Coruña, Spain., Bailón MM; Department of Internal Medicine, Hospital Clínico San Carlos, 28040 Madrid, Spain., Fernández-Garcés M; Department of Internal Medicine, Hospital Universitario Dr. Peset, 46017 Valencia, Spain., Cruz AF; Department of Internal Medicine, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain., García GMG; Department of Internal Medicine, Complejo Hospitalario Universitario de Badajoz, 06010 Badajoz, Spain., Rhyman N; Department of Internal Medicine, Hospital Moisès Broggi, Sant Joan Despí, 08970 Barcelona, Spain., Corral-Gudino L; Department of Internal Medicine, Hospital Universitario Río Hortega, 47012 Valladolid, Spain., Rodríguez-Mancheño AL; Department of Internal Medicine, Hospital Alto Guadalquivir, 23740 Jaén, Spain., De La Chica MN; Department of Internal Medicine, Hospital Nuestra Señora del Prado, 45600 Toledo, Spain., García AT; Department of Internal Medicine, Hospital General Universitario de Elda, 03600 Alicante, Spain., Alcalá JN; Department of Internal Medicine, Hospital de Pozoblanco, 14400 Córdoba, Spain., Jiménez PD; Department of Internal Medicine, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain., Trallero LER; Department of Internal Medicine, Hospital General Defensa, 50009 Zaragoza, Spain., Casanova PC; Department of Internal Medicine, Hospital Comarcal de Blanes, 17300 Girona, Spain., Núñez-Cortés JM; Department of Internal Medicine, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain., Casas-Rojo JM; Department of Internal Medicine, Hospital Infanta Cristina University Hospital, 28981 Madrid, Spain., On Behalf Of The Semi-Covid-Network
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2021 Oct 08; Vol. 10 (19). Date of Electronic Publication: 2021 Oct 08.
DOI: 10.3390/jcm10194610
Abstrakt: Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations.
Material and Methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID-19 Registry from March to November 2020.
Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236-996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp0 2 /Fi0 2 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation
Databáze: MEDLINE
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