Effect of Systemic Glucocorticoids on Mortality or Mechanical Ventilation in Patients With COVID-19

Journal of Hospital Medicine - Tập 15 Số 8 - Trang 489-493 - 2020
Marla J. Keller1, Elizabeth A. Kitsis2, Shitij Arora3, Jen-Ting Chen4, Shivani Agarwal5, Michael J. Ross6, Yaron Tomer5, William N. Southern3
1Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
2Division of Rheumatology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
3Division of Hospital Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
4Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
5Division of Endocrinology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
6Division of Nephrology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York

Tóm tắt

The efficacy of glucocorticoids in COVID-19 is unclear. This study was designed to determine whether systemic glucocorticoid treatment in COVID-19 patients is associated with reduced mortality or mechanical ventilation. This observational study included 1,806 hospitalized COVID-19 patients; 140 were treated with glucocorticoids within 48 hours of admission. Early use of glucocorticoids was not associated with mortality or mechanical ventilation. However, glucocorticoid treatment of patients with initial C-reactive protein (CRP) ≥20 mg/dL was associated with significantly reduced risk of mortality or mechanical ventilation (odds ratio, 0.23; 95% CI, 0.08- 0.70), while glucocorticoid treatment of patients with CRP <10 mg/dL was associated with significantly increased risk of mortality or mechanical ventilation (OR, 2.64; 95% CI, 1.39-5.03). Whether glucocorticoid treatment is associated with changes in mortality or mechanical ventilation in patients with high or low CRP needs study in prospective, randomized clinical trials. Journal of Hospital Medicine 2020;15:XXX-XXX. © 2020 Society of Hospital Medicine

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Journal of Hospital Medicine

Tập 15 Số 8

489-493

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