COVID-19感染期间的糖皮质激素治疗：是否会影响长COVID的发病率？

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI:10.1007/s10787-024-01576-y

Polina Specktor, Dana Hadar, Hilla Cohen

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引用次数: 0

摘要

背景：长COVID（LC）是COVID感染的一种常见并发症。它通常会导致认知障碍、肌痛、头痛和疲劳。目前尚未发现有效的治疗方法。我们的目的是探讨 COVID-19 感染期间糖皮质激素（GC）治疗对 LC 后期发展的影响：我们检查了 Clalit 健康服务机构的电子健康记录，以记录 COVID-19、GC 治疗和 LC 频率。我们还记录了背景诊断、人口统计学数据、住院率以及抗 COVID 药物的使用情况：有 1,322,599 例 COVID-19 感染病例符合纳入标准；13,530 例患者（1.02%）接受了 GC 治疗。149272名患者（占COVID-19患者的11.29%）被确诊为LC。年龄和女性性别是 LC 的预后风险因素（年龄 OR 为 1.06，女性性别 OR 为 1.4；P 值结论：COVID-19 期间的 GC 治疗是 LC 的预后风险因素：COVID-19 期间的 GC 治疗与 LC 的发展相关。体内和动物模型可用于探索这种相关性的机制。未来的研究方向还包括前瞻性研究。

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Glucocorticoid treatment during COVID-19 infection: does it affect the incidence of long COVID?

Background: Long COVID (LC) is a frequent complication of COVID infection. It usually results in cognitive impairment, myalgia, headache and fatigue. No effective treatment has been found yet. We aimed to explore the effect of glucocorticoid (GC) treatment during COVID-19 infection on the later development of LC.

Methods: We examined electronic health records from Clalit Health Services for documentation of COVID-19, GC treatment, and LC frequency. Background diagnoses, demographic data, hospitalization rates, and the use of anti-COVID drugs were recorded.

Results: 1,322,599 cases of COVID-19 infection met the inclusion criteria; 13,530 patients (1.02%) received GC treatment. 149,272 patients, 11.29% of COVID-19 patients were diagnosed with LC. Age and female gender were prognostic risk factors for LC (OR 1.06 for age, OR 1.4 for female gender; p value < 0.0001). Background psychiatric diagnoses, migraine, backache and irritable bowel syndrome were predisposing conditions for LC (OR 2.7, p value < .0001). Higher BMI was associated with a greater probability of LC (OR of 1.25 for obese population). COVID patients who received GC were diagnosed with LC more frequently: 2294 cases (16.95%) compared to 146,978 cases (11.23%) in the non-GC group; (adjusted OR of 1.28 ± 0.07, 95% CI, p < 0.0001).

Conclusions: GC treatment during COVID-19 is correlated with the development of LC. In vivo and animal models may be used to explore the mechanism of this correlation. Future directions include prospective studies as well.

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来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]