Role of the early short-course corticosteroids treatment in ARDS caused by COVID-19: A single-center, retrospective analysis.
Adv Med Sci
; 66(2): 262-268, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-34022675
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. PATIENTS ANDMETHODS:
This is a single-center, retrospective study considering the patients with confirmed COVID-19 pneumonia admitted to our hospital between 9th March and 15th June 2020. Two groups were considered early high-dose of methyl-prednisolone (eHDM; n â= â31) and the control group (n â= â52). Patients in the eHDM group received the dose of 5-8 âmg/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.RESULTS:
Significant differences between the two groups were length of hospitalization (21.5 vs 28.4 days, p â= â0.026), length of non-invasive ventilation (NIV) or mechanical ventilation (11.5 vs 14.5 days, p â= â0.031), death (5 vs 12, p â= â0.006) and clinical improvement (16 vs 11, p=0.018). The following factors were related to in-hospital mortality in the multivariateanalysis:
comorbidities (OR â= â2.919; 95%CI â= â1.515-16.705; p<0.001), days from the onset of symptoms and the hospital admission (OR â= â1.404; 95%CI â= â1.069-12.492; p â= â0.011), PaO2/FiO2 (P/F) ratio (OR â= â3.111; 95%CI â= â2.334-16.991; p â= â0.009) and eHDM treatment (OR â= â0.741; 95%CI â= â0.129-0.917; p â= â0.007).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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Viral
/
Síndrome do Desconforto Respiratório
/
Metilprednisolona
/
SARS-CoV-2
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COVID-19
/
Pulmão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Adv Med Sci
Assunto da revista:
MEDICINA
Ano de publicação:
2021
Tipo de documento:
Article