학술논문
Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19
Document Type
article
Author
Matteo Pagnesi; Riccardo M. Inciardi; Carlo M. Lombardi; Piergiuseppe Agostoni; Pietro Ameri; Lucia Barbieri; Antonio Bellasi; Rita Camporotondo; Claudia Canale; Valentina Carubelli; Stefano Carugo; Francesco Catagnano; Laura A. Dalla Vecchia; Gian Battista Danzi; Mattia Di Pasquale; Margherita Gaudenzi; Stefano Giovinazzo; Massimiliano Gnecchi; Marco Guazzi; Annamaria Iorio; Maria Teresa La Rovere; Sergio Leonardi; Gloria Maccagni; Massimo Mapelli; Davide Margonato; Marco Merlo; Luca Monzo; Andrea Mortara; Vincenzo Nuzzi; Massimo Piepoli; Italo Porto; Andrea Pozzi; Filippo Sarullo; Gianfranco Sinagra; Chiara Tedino; Daniela Tomasoni; Maurizio Volterrani; Gregorio Zaccone; Michele Senni; Marco Metra
Source
International Journal of Infectious Diseases, Vol 108, Iss , Pp 270-273 (2021)
Subject
Language
English
ISSN
1201-9712
Abstract
Background: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality. Methods: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality. Results: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26–0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (100 mg/L). Conclusions: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.