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10.1128/AAC.01168-20

http://scihub22266oqcxt.onion/10.1128/AAC.01168-20
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32571831!7449182!32571831
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suck abstract from ncbi


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pmid32571831      Antimicrob+Agents+Chemother 2020 ; 64 (9): ä
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  • A Retrospective Controlled Cohort Study of the Impact of Glucocorticoid Treatment in SARS-CoV-2 Infection Mortality #MMPMID32571831
  • Fernandez-Cruz A; Ruiz-Antoran B; Munoz-Gomez A; Sancho-Lopez A; Mills-Sanchez P; Centeno-Soto GA; Blanco-Alonso S; Javaloyes-Garachana L; Galan-Gomez A; Valencia-Alijo A; Gomez-Irusta J; Payares-Herrera C; Morras-Torre I; Sanchez-Chica E; Delgado-Tellez-de-Cepeda L; Callejas-Diaz A; Ramos-Martinez A; Munez-Rubio E; Avendano-Sola C
  • Antimicrob Agents Chemother 2020[Aug]; 64 (9): ä PMID32571831show ga
  • Evidence to support the use of steroids in coronavirus disease 2019 (COVID-19) pneumonia is lacking. We aim to determine the impact of steroid use for COVID-19 pneumonia on hospital mortality. We performed a single-center retrospective cohort study in a university hospital in Madrid, Spain, during March of 2020. To determine the role of steroids in in-hospital mortality, patients admitted with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia and treated with steroids were compared to patients not treated with steroids, and we adjusted with a propensity score for patients on steroid treatment. Survival times were compared using the log rank test. Different steroid regimens were compared and adjusted with a second propensity score. During the study period, 463 out of 848 hospitalized patients with COVID-19 pneumonia fulfilled inclusion criteria. Among them, 396 (46.7%) patients were treated with steroids and 67 patients were not. Global mortality was 15.1%. The median time to steroid treatment from symptom onset was 10 days (interquartile range [IQR], 8 to 13 days). In-hospital mortality was lower in patients treated with steroids than in controls (13.9% [55/396] versus 23.9% [16/67]; hazard ratio [HR], 0.51 [95% confidence interval, 0.27 to 0.96]; P = 0.044). Steroid treatment reduced mortality by 41.8% relative to the mortality with no steroid treatment (relative risk reduction, 0.42 [95% confidence interval, 0.048 to 0.65]). Initial treatment with 1 mg/kg of body weight/day of methylprednisolone versus steroid pulses was not associated with in-hospital mortality (13.5% [42/310] versus 15.1% [13/86]; odds ratio [OR], 0.880 [95% confidence interval, 0.449 to 1.726]; P = 0.710). Our results show that the survival of patients with SARS-CoV-2 pneumonia is higher in patients treated with glucocorticoids than in those not treated. Rates of in-hospital mortality were not different between initial regimens of 1 mg/kg/day of methylprednisolone and glucocorticoid pulses.
  • |Aged[MESH]
  • |Antiviral Agents/*therapeutic use[MESH]
  • |Azithromycin/*therapeutic use[MESH]
  • |Betacoronavirus/*drug effects/immunology/pathogenicity[MESH]
  • |COVID-19[MESH]
  • |Cardiovascular Diseases/drug therapy/immunology/mortality/virology[MESH]
  • |Comorbidity[MESH]
  • |Coronavirus Infections/*drug therapy/immunology/mortality/virology[MESH]
  • |Diabetes Mellitus/drug therapy/immunology/mortality/virology[MESH]
  • |Drug Administration Schedule[MESH]
  • |Drug Combinations[MESH]
  • |Drug Therapy, Combination[MESH]
  • |Dyslipidemias/drug therapy/immunology/mortality/virology[MESH]
  • |Female[MESH]
  • |Hospitals, University[MESH]
  • |Humans[MESH]
  • |Hydroxychloroquine/*therapeutic use[MESH]
  • |Intensive Care Units[MESH]
  • |Interferons/*therapeutic use[MESH]
  • |Length of Stay/statistics & numerical data[MESH]
  • |Lopinavir/*therapeutic use[MESH]
  • |Male[MESH]
  • |Methylprednisolone/*therapeutic use[MESH]
  • |Middle Aged[MESH]
  • |Neoplasms/drug therapy/immunology/mortality/virology[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*drug therapy/immunology/mortality/virology[MESH]
  • |Retrospective Studies[MESH]
  • |Ritonavir/*therapeutic use[MESH]
  • |SARS-CoV-2[MESH]


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