Non-severe immunosuppression might be associated with a lower risk of moderate-severe acute respiratory distress syndrome in COVID-19: A pilot study
| Autor: | Nuria García-Barragán, Pedro Gullón, Javier Martínez-Sanz, Enric Monreal, Juan Luis Chico-García, Araceli Alonso-Canovas, Jaime Masjuan, Lucienne Costa-Frossard, Jesús Fortún, Paula Pérez-Torre, J.L. López-Sendón, Javier Buisán, Elena Natera-Villalba, Luis Máiz-Carro, Sainz de la Maza S, Álvaro Beltrán-Corbellini, Beatriz Montero-Errasquín, Rafael Toledano, Iñigo Corral, Guillermo García-Ribas, Luis Manzano, María Consuelo Matute-Lozano |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty ARDS medicine.medical_treatment Pilot Projects Lower risk Severity of Illness Index Cohort Studies 03 medical and health sciences 0302 clinical medicine Virology Internal medicine Severity of illness Clinical endpoint medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Immunosuppression Therapy Respiratory Distress Syndrome business.industry Coinfection SARS-CoV-2 COVID-19 Retrospective cohort study Immunosuppression Middle Aged medicine.disease Hospitalization Infectious Diseases Spain Cohort 030211 gastroenterology & hepatology Female business Cohort study |
| Zdroj: | Journal of Medical Virology |
| ISSN: | 1096-9071 |
| Popis: | The role of immunosuppression among coronavirus disease 2019 (COVID-19) patients has not been elucidated and management may be challenging. This observational study included confirmed COVID-19 patients. The primary endpoint was the development of moderate-severe acute respiratory distress syndrome (ARDS). Time to moderate-severe ARDS, the need for mechanical or noninvasive ventilation (MV/NIV), death, and a composite of death or MV/NIV were secondary endpoints. Of 138 patients included, 27 (19.6%) were immunosuppressed (IS) and 95 (68.8%) were male, with a median (IQR) age of 68 (54-78) years. A significantly lower proportion of IS patients (25.9%) compared to non-IS patients (52.3%) developed moderate-severe ARDS, in both unadjusted (0.32; 95% CI, 0.13-0.83; p = .017) and adjusted (aOR, 0.25; 95% CI, 0.08-0.80; p = .019) analyses. After stratifying by pathologies, only IS patients with autoimmune diseases remained significant (aOR 0.25; 95% CI, 0.07-0.98; p = .046). Nonsignificant trends toward a longer time to moderate or severe ARDS, a lower need for MV/NIV, and a lower risk of death or MV/NIV were detected among IS. In our cohort of COVID-19 patients, nonsevere immunosuppression was associated with a lower risk of moderate-severe ARDS, especially among AD. This suggests a potential protective effect from a hypothesized hyper-inflammatory response. |
| Databáze: | OpenAIRE |
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