Effect of methylprednisolone in reducing severe COVID-19 and mortality in high-risk patients: A retrospective study.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI:10.1177/20503121241276683
Yan Xiao, Jinwei Wang, Kai Yang, Meiling Jiang, Jialin Luo, Kun Chen, Bo Zhang
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引用次数: 0

Abstract

Introduction: The treatment of COVID-19 patients, especially high-risk patients, remains a large challenge. Glucocorticoids have been accepted as effective medicines for severe COVID-19. However, the glucocorticoid usage guidelines do not cover all the indications for high-risk patients.

Objective: To identify more effective treatments for high-risk patients with COVID-19, this retrospective study analyzed routine epidemiological, clinical, and laboratory data from 33 high-risk patients with COVID-19 in Beijing Gobroad Boren Hospital, Beijing, China, most of whom responded well to treatment.

Methods: Severe acute respiratory syndrome coronavirus-2 infection was confirmed via real-time reverse transcriptase polymerase chain reaction assays. Outcome measures such as duration of mechanical ventilation, intensive care unit length of stay, and 28-day mortality were analyzed. Patients were divided into two groups: mild to moderate COVID-19 (n = 26) and severe COVID-19 (n = 7). Chest computed tomography images were used to guide methylprednisolone administration or withdrawal.

Results: Upon intensive care unit admission, 12.1% of patients were mechanically ventilated with an average partial pressure of oxygen/fraction of inspired oxygen(PaO2/FiO2) ratio of 279 ± 146. No coinfections with other endemic viruses were observed. The duration of mechanical ventilation was 16 days (interquartile range: 8-28); the intensive care unit length of stay was 11 (interquartile range: 2-33) days; and the 28-day total mortality was 3.0%.

Conclusion: Multivariate regression analysis revealed that low-dose, timely methylprednisolone administration was associated with a lower severe COVID-19 rate and mortality in high-risk patients. For high-risk patients, once there are ground-glass opacities (GGO) in the computed tomography image, continuous and low-dose methylprednisolone administration promotes inflammation remission and protects them from severe COVID-19 or mortality.

甲基强的松龙在降低高危患者严重 COVID-19 和死亡率方面的效果:一项回顾性研究。
导言:治疗 COVID-19 患者,尤其是高危患者,仍然是一个巨大的挑战。糖皮质激素已被视为治疗重症 COVID-19 的有效药物。然而,糖皮质激素使用指南并未涵盖高危患者的所有适应症:为了找出针对 COVID-19 高危患者更有效的治疗方法,本回顾性研究分析了北京国博博仁医院 33 例 COVID-19 高危患者的常规流行病学、临床和实验室数据,其中大多数患者对治疗反应良好:方法:通过实时逆转录酶聚合酶链反应测定确认严重急性呼吸综合征冠状病毒-2感染。分析结果包括机械通气时间、重症监护室住院时间和 28 天死亡率。患者分为两组:轻度至中度 COVID-19(26 人)和重度 COVID-19(7 人)。胸部计算机断层扫描图像用于指导甲基强的松龙的使用或停用:入院时,12.1%的患者接受了机械通气,平均氧分压/吸入氧分压(PaO2/FiO2)比值为 279 ± 146。未发现合并感染其他流行病毒的情况。机械通气时间为16天(四分位数间距:8-28);重症监护室住院时间为11天(四分位数间距:2-33);28天总死亡率为3.0%:多变量回归分析显示,小剂量、及时给予甲基强的松龙与高危患者较低的严重 COVID-19 发生率和死亡率相关。对于高危患者,一旦计算机断层扫描图像中出现磨玻璃不透明(GGO),持续、低剂量的甲基强的松龙用药可促进炎症缓解,保护他们免受严重 COVID-19 或死亡的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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