Efficacy of corticosteroids in non-intensive care unit patients with COVID-19 pneumonia from the New York Metropolitan region
| العنوان: | Efficacy of corticosteroids in non-intensive care unit patients with COVID-19 pneumonia from the New York Metropolitan region |
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| المؤلفون: | Kuldeep Ghosh, Joanna Lenik, Hossam Amin, Monil Majmundar, Rajkumar Doshi, Imnett Habtes, Tikal Kansara, Hansang Park, Shobhana Chaudhari, Ashish Kumar, Palak Shah |
| المصدر: | PLoS ONE, Vol 15, Iss 9, p e0238827 (2020) PLoS ONE PLOS ONE, 15(9):e0238827 |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 0301 basic medicine, Male, Viral Diseases, Pulmonology, Epidemiology, medicine.medical_treatment, Kaplan-Meier Estimate, Steroid Therapy, law.invention, Medical Conditions, 0302 clinical medicine, law, Adrenal Cortex Hormones, Medicine and Health Sciences, Intubation, 030212 general & internal medicine, Hospital Mortality, Immune Response, Respiratory Distress Syndrome, Multidisciplinary, Pharmaceutics, Hazard ratio, Middle Aged, Intensive care unit, Hospitals, Chemistry, Intensive Care Units, Infectious Diseases, Treatment Outcome, Physical Sciences, Cohort, Medicine, Corticosteroid, Female, Coronavirus Infections, Research Article, Chemical Elements, Adult, medicine.medical_specialty, medicine.drug_class, Corticosteroid Therapy, Science, Immunology, Pneumonia, Viral, New York, Surgical and Invasive Medical Procedures, Lower risk, 03 medical and health sciences, Betacoronavirus, Signs and Symptoms, Drug Therapy, Internal medicine, medicine, Humans, Pandemics, Aged, Proportional Hazards Models, Retrospective Studies, Inflammation, Proportional hazards model, business.industry, SARS-CoV-2, COVID-19, Medical risk factors, Corticosteroid therapy, Intensive care units, Pneumonia, Oxygen, Biology and Life Sciences, Covid 19, Retrospective cohort study, medicine.disease, Health Care, 030104 developmental biology, Health Care Facilities, Medical Risk Factors, Clinical Medicine, business |
| الوصف: | IntroductionThe role of systemic corticosteroid as a therapeutic agent for patients with COVID-19 pneumonia is controversial.ObjectiveThe purpose of this study was to evaluate the effect of corticosteroids in non-intensive care unit (ICU) patients with COVID-19 pneumonia complicated by acute hypoxemic respiratory failure (AHRF).MethodsThis was a single-center retrospective cohort study, from the 16th March, 2020 to 30th April, 2020; final follow-up on 10th May, 2020. 265 patients consecutively admitted to the non-ICU wards with laboratory-confirmed COVID-19 pneumonia were screened for inclusion. 205 patients who developed AHRF (SpO2/FiO2 ≤ 440 or PaO2/FiO2 ≤ 300) were only included in the final study. Direct admission to the Intensive care unit (ICU), patients developing composite primary outcome within 24 hours of admission, and patients who never became hypoxic during their stay in the hospital were excluded. Patients divided into two cohort based on corticosteroid. The primary outcome was a composite of ICU transfer, intubation, or in-hospital mortality. Secondary outcomes were ICU transfer, intubation, in-hospital mortality, discharge, length of stay and daily trend of SpO2/FiO2 (SF) ratio from the index date. Cox-proportional hazard regression was implemented to analyze the time to event outcomes.ResultAmong 205 patients, 60 (29.27%) were treated with corticosteroid. The mean age was ∼57 years, and ∼75% were men. Thirteen patients (22.41%) developed a primary composite outcome in the corticosteroid cohort vs. 54 (37.5%) patients in the non-corticosteroid cohort (P=0.039). The adjusted hazard ratio (HR) for the development of the composite primary outcome was 0.15 (95% CI, 0.07 – 0.33; P 2/FiO2 over time compared to the non-corticosteroid cohort who experience decreasing SpO2/FiO2 over time.ConclusionAmong non-ICU patients hospitalized with COVID-19 pneumonia complicated by AHRF, treatment with corticosteroid was associated with a significantly lower risk of the primary composite outcome of ICU transfer, intubation, or in-hospital death. |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::90940d9dd0c858b4178872cee1d8d511Test https://pubmed.ncbi.nlm.nih.gov/32903258Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....90940d9dd0c858b4178872cee1d8d511 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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