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

被引：92
|
作者：
Keller, Marla J. [1 ,2 ]
Kitsis, Elizabeth A. [2 ,3 ]
Arora, Shitij [2 ,4 ]
Chen, Jen-Ting [2 ,5 ]
Agarwal, Shivani [2 ,6 ]
Ross, Michael J. [2 ,7 ]
Tomer, Yaron [2 ,6 ]
Southern, William [2 ,4 ]
机构：
[1] Montefiore Med Ctr, Dept Med, Div Infect Dis, Bronx, NY 10467 USA
[2] Albert Einstein Coll Med, Bronx, NY 10467 USA
[3] Montefiore Med Ctr, Dept Med, Div Rheumatol, Bronx, NY 10467 USA
[4] Montefiore Med Ctr, Dept Med, Div Hosp Med, Bronx, NY 10467 USA
[5] Montefiore Med Ctr, Dept Med, Div Crit Care Med, Bronx, NY 10467 USA
[6] Montefiore Med Ctr, Dept Med, Div Endocrinol, Bronx, NY 10467 USA
[7] Montefiore Med Ctr, Dept Med, Div Nephrol, Bronx, NY 10467 USA
来源：
JOURNAL OF HOSPITAL MEDICINE | 2020年 / 15卷 / 08期
关键词：
CORTICOSTEROID TREATMENT;
D O I：
10.12788/jhm.3497
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
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. (c) 2020 Society of Hospital Medicine
引用
收藏
页码：489 / 493
页数：5
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