Author: Fusina, Federica; Albani, Filippo; Granato, Enza; Meloni, Angelo; Rozzini, Renzo; Sabatini, Tony; Stellini, Roberto; Terragnoli, Paolo; Rosano, Antonio; Abu Hilal, Mohammed; Natalini, Giuseppe
Title: Effect of Corticosteroids on Mortality in Hospitalized COVIDâ€19 Patients Not Receiving Invasive Mechanical Ventilation Cord-id: m1f29ggl Document date: 2021_4_19
ID: m1f29ggl
Snippet: The most beneficial effect of corticosteroid therapy in COVIDâ€19 patients has been shown in subjects receiving invasive mechanical ventilation (IMV), corresponding to a score of 6 on the World Health Organization (WHO) COVIDâ€19 Ordinal Scale for Clinical Improvement (OSCI). The aim of this observational, singleâ€center, prospective study was to assess the association between corticosteroids and hospital mortality in coronavirus disease 2019 (COVIDâ€19) patients who did not receive IMV (OSC
Document: The most beneficial effect of corticosteroid therapy in COVIDâ€19 patients has been shown in subjects receiving invasive mechanical ventilation (IMV), corresponding to a score of 6 on the World Health Organization (WHO) COVIDâ€19 Ordinal Scale for Clinical Improvement (OSCI). The aim of this observational, singleâ€center, prospective study was to assess the association between corticosteroids and hospital mortality in coronavirus disease 2019 (COVIDâ€19) patients who did not receive IMV (OSCI 3–5). Included were 1,311 COVIDâ€19 patients admitted to nonintensive care wards, and they were divided in two cohorts: (i) 480 patients who received corticosteroid therapy and (ii) 831 patients who did not. The median daily dose was of 8 mg of dexamethasone or equivalent, with a mean therapy duration of 5 (3–9) days. The indication to administer or withhold corticosteroids was given by the treating physician. Inâ€hospital mortality was similar between the two cohorts after adjusting for possible confounders (adjusted odds ratio (ORadj) 1.04, 95% confidence interval (CI), 0.81–1.34, P = 0.74). There was also no difference in Intensive Care Unit (ICU) admission (ORadj 0.81, 95% CI, 0.56–1.17, P = 0.26). COVIDâ€19 patients with noninvasive mechanical ventilation (NIMV) had a lower risk for ICU admission if they received steroid therapy (ORadj 0.58, 95% CI, 0.35–0.94, P = 0.03). In conclusion, corticosteroids were overall not associated with a difference in hospital mortality for patients with COVIDâ€19 with OSCI 3–5. In the subgroup of patients with NIMV (OSCI 5), corticosteroids reduced ICU admission, whereas the effect on mortality requires further studies.
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