Clinical Outcomes Associated With Methylprednisolone in Mechanically Ventilated Patients With COVID-19.
Clin Infect Dis
; 72(9): e367-e372, 2021 05 04.
Article
em En
| MEDLINE
| ID: mdl-32772069
ABSTRACT
BACKGROUND:
The efficacy and safety of methylprednisolone in mechanically ventilated patients with acute respiratory distress syndrome resulting from coronavirus disease 2019 (COVID-19) are unclear. In this study, we evaluated the association between use of methylprednisolone and key clinical outcomes.METHODS:
Clinical outcomes associated with the use of methylprednisolone were assessed in an unmatched, case-control study; a subset of patients also underwent propensity-score matching. Patients were admitted between 1 March and 12 April, 2020. The primary outcome was ventilator-free days by 28 days after admission. Secondary outcomes included extubation, mortality, discharge, positive cultures, and hyperglycemia.RESULTS:
A total of 117 patients met inclusion criteria. Propensity matching yielded a cohort of 42 well-matched pairs. Groups were similar except for hydroxychloroquine and azithromycin use, which were more common in patients who did not receive methylprednisolone. Mean ventilator-free days were significantly higher in patients treated with methylprednisolone (6.21â ±â 7.45 vs 3.14â ±â 6.22; Pâ =â .044). The probability of extubation was also increased in patients receiving methylprednisolone (45% vs 21%; Pâ =â .021), and there were no significant differences in mortality (19% vs 36%; Pâ =â .087). In a multivariable linear regression analysis, only methylprednisolone use was associated with a higher number of ventilator-free days (Pâ =â .045). The incidence of positive cultures and hyperglycemia were similar between groups.CONCLUSIONS:
Methylprednisolone was associated with increased ventilator-free days and higher probability of extubation in a propensity-score matched cohort. Randomized, controlled studies are needed to further define methylprednisolone use in patients with COVID-19.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Metilprednisolona
/
COVID-19
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos