The WEST Study: A Retrospective and Multicentric Study on the Impact of Steroid Therapy in West Nile Encephalitis.

Autor: Colaneri M; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Lissandrin R; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Calia M; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Bassoli C; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Seminari E; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Pavesi A; Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Rovida F; Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Baldanti F; Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Muzzi A; Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Chichino G; Division of Infectious Diseases, ASST Ospedale of Alessandria, Alessandria, Italy., Regazzetti A; Division of Infectious Diseases, Ospedale Delmati di Sant'Angelo Lodigiano, Lodi, Italy., Grecchi C; Division of Infectious Diseases, Ospedale Delmati di Sant'Angelo Lodigiano, Lodi, Italy., Pan A; ASST di Cremona, Cremona, Italy., Lupi M; ASST di Cremona, Cremona, Italy., Franceschini E; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria 'Policlinico of Modena,' Modena, Italy., Mussini C; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria 'Policlinico of Modena,' Modena, Italy.; Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy., Bruno R; UOC Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2023 Feb 20; Vol. 10 (3), pp. ofad092. Date of Electronic Publication: 2023 Feb 20 (Print Publication: 2023).
DOI: 10.1093/ofid/ofad092
Abstrakt: Background: The use of steroid therapy in potentially life-threatening neuroinvasive forms of West Nile infection (WNND) is controversial. The aim of this study is to assess the efficacy of steroid therapy in reducing intrahospital mortality, length of stay, and neurological sequelae at discharge.
Methods: This was a multicenter, retrospective, observational study conducted in 5 hospitals in Northern Italy, headed by the Fondazione IRCSS Policlinico San Matteo (Pavia). We extracted all patient data with WNND diagnoses, comparing patients who received steroid treatment with patients who did not receive steroid treatment between January 2014 and January 2022. Comparisons between the 2 groups were performed using chi-square tests for categorical variables and Mann-Whitney tests for non-normal continuous data, and a generalized linear model for the binomial family was carried out.
Results: Data from 65 WNND patients were extracted. Among these patients, 33 (50.7%) received steroid therapy at any point during their hospitalization. Receiving steroid therapy did not significantly reduce intrahospital mortality (odds ratio [OR], 1.70; 95% CI, 0.3-13.8; P = .89) or neurological sequelae at discharge (OR, 0.53; 95% CI, 0.16-1.76; P = .47).
Conclusions: Steroid treatment is currently used on a single-case basis in severe WNND. More prospective data are needed to demonstrate a protective effect on mortality and neurological sequelae.
Competing Interests: Potential conflicts of interest. All authors: no reported conflicts.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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