Selected article for: "ARDS respiratory distress syndrome and controversial role"
Author: Boglione, Lucio; Olivieri, Carlo; Rostagno, Roberto; Poletti, Federica; Moglia, Roberta; Bianchi, Bianca; Esposito, Maria; Biffi, Stefano; Borrè, Silvio
Title: Role of the early short-course corticosteroids treatment in ARDS caused by COVID-19: a single-center, retrospective analysis
  • Cord-id: qe1spo5o
  • Document date: 2021_4_24
    • ID: qe1spo5o
    Snippet: PURPOSE: Severe coronavirus disease 2019 (COVID-19) is strongly related to interstitial pneumonia with frequent development of acute respiratory distress syndrome (ARDS). The role of corticosteroids (CS) treatment in these patients is still controversial. Some studies evidenced a possible role of an early short-term course of CS treatment in the treatment of severe pneumonia. PATIENTS AND METHODS: This is a single-center, retrospective study considering the patients with confirmed COVID-19 pneum
    Document: PURPOSE: Severe coronavirus disease 2019 (COVID-19) is strongly related to interstitial pneumonia with frequent development of acute respiratory distress syndrome (ARDS). The role of corticosteroids (CS) treatment in these patients is still controversial. Some studies evidenced a possible role of an early short-term course of CS treatment in the treatment of severe pneumonia. PATIENTS AND METHODS: This is a single-center, retrospective study considering the patients with confirmed COVID-19 pneumonia admitted to our hospital between 9(th) March and 15(th) June 2020. Two groups were considered: early high-dose of methyl-prednisolone (eHDM; n=31) and the control group (n=52). Patients in the eHDM group received the dose of 5-8mg/kg/day of methyl-prednisolone for 2 consecutive days. Primary outcome was the mortality evaluation; secondary outcomes were clinical improvement, side-effects and laboratory/radiographic changes. RESULTS: Significant differences between the two groups were: length of hospitalization (21.5 vs 28.4 days, p=0.026), length of non-invasive ventilation (NIV) or mechanical ventilation (11.5 vs 14.5 days, p=0.031), death (5 vs 12, p=0.006) and clinical improvement (16 vs 11, p=0.018). The following factors were related to in-hospital mortality in the multivariate analysis: comorbidities (OR=2.919; 95%CI=1.515-16.705; p<0.001), days from the onset of symptoms and the hospital admission (OR=1.404; 95%CI=1.069-12.492; p=0.011), PaO(2)/FiO(2) (P/F) ratio (OR=3.111; 95%CI=2.334-16.991; p=0.009) and eHDM treatment (OR=0.741; 95%CI=0.129-0.917; p=0.007). CONCLUSION: The eHDM is an interesting and promising approach in the ARDS related to COVID-19 pneumonia, which reduces mortality, length of hospitalization and the need for mechanical ventilation.

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