In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 1 ( 2022-1-21), p. e0261711-
Abstract:
To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses. Results Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, 2,216 (46%) specifically received megadoses. Age was a factor that differed between those who received megadoses therapy versus those who did not in a significant manner (69 years [IQR 59–79] vs 73 years [IQR 61–83] ; p 〈 .001). Radiological and analytical findings showed a higher use of megadoses therapy among patients with an interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the univariate study it appears that steroid use is associated with increased mortality (OR 2.07 95% CI 1.91–2.24 p 〈 .001) and megadose use with increased survival (OR 0.84 95% CI 0.75–0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32–1.80; p 〈 .001). There is no difference between megadoses and low-dose (p .298). Although, there are differences in the use of megadoses versus low-dose in terms of complications, mainly infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI 0.71–0.95; p 〈 .001 and OR 0.80 95% CI 0.65–0.97; p 〈 .001) respectively. Conclusion There is no difference in mortality with megadoses versus low-dose, but there is a lower incidence of infectious complications with glucocorticoid megadoses.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0261711
DOI:
10.1371/journal.pone.0261711.t001
DOI:
10.1371/journal.pone.0261711.t002
DOI:
10.1371/journal.pone.0261711.t003
DOI:
10.1371/journal.pone.0261711.t004
DOI:
10.1371/journal.pone.0261711.t005
DOI:
10.1371/journal.pone.0261711.t006
DOI:
10.1371/journal.pone.0261711.t007
DOI:
10.1371/journal.pone.0261711.s001
DOI:
10.1371/journal.pone.0261711.s002
DOI:
10.1371/journal.pone.0261711.s003
DOI:
10.1371/journal.pone.0261711.r001
DOI:
10.1371/journal.pone.0261711.r002
DOI:
10.1371/journal.pone.0261711.r003
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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