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10.1371/journal.pone.0243964

http://scihub22266oqcxt.onion/10.1371/journal.pone.0243964
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33507958!7842890!33507958
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suck abstract from ncbi


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pmid33507958      PLoS+One 2021 ; 16 (1): e0243964
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  • High-dose corticosteroid pulse therapy increases the survival rate in COVID-19 patients at risk of hyper-inflammatory response #MMPMID33507958
  • Lopez Zuniga MA; Moreno-Moral A; Ocana-Granados A; Padilla-Moreno FA; Castillo-Fernandez AM; Guillamon-Fernandez D; Ramirez-Sanchez C; Sanchez-Palop M; Martinez-Colmenero J; Pimentel-Villar MA; Blazquez-Rosello S; Moreno-Sanchez JJ; Lopez-Vilchez M; Prior-Sanchez I; Jodar-Moreno R; Lopez Ruz MA
  • PLoS One 2021[]; 16 (1): e0243964 PMID33507958show ga
  • OBJECTIVE: Test whether high dose corticosteroid pulse therapy (HDCPT) with either methylprednisolone or dexamethasone is associated with increased survival in COVID-19 patients at risk of hyper-inflammatory response. Provide some initial diagnostic criteria using laboratory markers to stratify these patients. METHODS: This is a prospective observational study, 318 met the inclusion criteria. 64 patients (20.1%) were treated with HDCPT by using at least 1.5mg/kg/24h of methylprednisolone or dexamethasone equivalent. A multivariate Cox regression (controlling for co-morbidities and other therapies) was carried out to determine whether HDCPT (among other interventions) was associated with decreased mortality. We also carried out a 30-day time course analysis of laboratory markers between survivors and non-survivors, to identify potential markers for patient stratification. RESULTS: HDCPT showed a statistically significant decrease in mortality (HR = 0.087 [95% CI 0.021-0.36]; P < 0.001). 30-day time course analysis of laboratory marker tests showed marked differences in pro-inflammatory markers between survivors and non-survivors. As diagnostic criteria to define the patients at risk of developing a COVID-19 hyper-inflammatory response, we propose the following parameters (IL-6 > = 40 pg/ml, and/or two of the following: C-reactive protein > = 100 mg/L, D-dimer > = 1000 ng/ml, ferritin > = 500 ng/ml and lactate dehydrogenase > = 300 U/L). CONCLUSIONS: HDCPT can be an effective intervention to increase COVID-19 survival rates in patients at risk of developing a COVID-19 hyper-inflammatory response, laboratory marker tests can be used to stratify these patients who should be given HDCPT. This study is not a randomized clinical trial (RCT). Future RCTs should be carried out to confirm the efficacy of HDCPT to increase the survival rates of COVID-19.
  • |*COVID-19 Drug Treatment[MESH]
  • |Adrenal Cortex Hormones/*administration & dosage[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |COVID-19/immunology/mortality[MESH]
  • |Cytokine Release Syndrome/*drug therapy/immunology[MESH]
  • |Dexamethasone/pharmacology[MESH]
  • |Female[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Inflammation/immunology/prevention & control[MESH]
  • |Male[MESH]
  • |Methylprednisolone/pharmacology[MESH]
  • |Middle Aged[MESH]
  • |Prospective Studies[MESH]
  • |SARS-CoV-2/isolation & purification[MESH]
  • |Spain/epidemiology[MESH]


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