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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Sci+Rep 2020 ; 10 (1): 21291 Nephropedia Template TP
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Viral clearance after early corticosteroid treatment in patients with moderate or severe covid-19 #MMPMID33277573
Spagnuolo V; Guffanti M; Galli L; Poli A; Querini PR; Ripa M; Clementi M; Scarpellini P; Lazzarin A; Tresoldi M; Dagna L; Zangrillo A; Ciceri F; Castagna A
Sci Rep 2020[Dec]; 10 (1): 21291 PMID33277573show ga
The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO(2)/FiO(2) = 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or = 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p < 0.001). Time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users (p = 0.985). According to multivariate analysis, SARS-CoV-2 clearance was associated with age = 70 years, a shorter duration of symptoms at admission, a baseline PaO(2)/FiO(2) > 200 mmHg, and a lymphocyte count at admission > 1.0 x 10(9)/L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.