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Corticosteroid therapy for patients with COVID-19 pneumonia: a before-after study.
Int J Antimicrob Agents. 2020 Aug; 56(2):106077.IJ

Abstract

Anti-inflammatory drugs such as corticosteroids may beneficially modulate the host inflammatory response to coronavirus disease 2019 (COVID-19) pneumonia. The aim of this study was to evaluate the impact of addition of corticosteroids to the hospital protocol for treatment of suspected or confirmed COVID-19 pneumonia on rates of death or intensive care unit (ICU) admission. A before-after study was performed to evaluate the effect of addition of corticosteroids to our institution's COVID-19 treatment protocol on hospital mortality. A total of 257 patients with a COVID-19 diagnosis were included in this study between 3 March 2020 and 14 April 2020. As corticosteroids were widely used after 27 March 2020, two periods were considered for the purposes of this study: the 'before' period from 3-20 March 2020 (n = 85); and the 'after' period from 26 March-14 April 2020 (n = 172). The 'after' period was associated with a lower risk of death [adjusted hazard ratio (aHR) = 0.47, 95% confidence interval (CI) 0.23-0.97; P = 0.04] and a lower risk of ICU admission or of death before ICU admission (aHR = 0.37, 95% CI 0.21-0.64; P = 0.0005) by multivariate analysis adjusted for age, National Early Warning score and institutionalisation status. In conclusion, addition of corticosteroids to our institution's COVID-19 treatment protocol was associated with a significant reduction in hospital mortality in the 'after' period.

Authors+Show Affiliations

Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, Reims, France. Electronic address: fbanisadr@chu-reims.fr.Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, Reims, France.Department of Research and Public Health, Reims University Hospital, Reims, France.Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, Reims, France.Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Reims University Hospital, Reims, France.Department of Virology, Reims University Hospital, Reims, France.Department of Research and Public Health, Reims University Hospital, Reims, France.Department of Research and Public Health, Reims University Hospital, Reims, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32634602

Citation

Bani-Sadr, Firouzé, et al. "Corticosteroid Therapy for Patients With COVID-19 Pneumonia: a Before-after Study." International Journal of Antimicrobial Agents, vol. 56, no. 2, 2020, p. 106077.
Bani-Sadr F, Hentzien M, Pascard M, et al. Corticosteroid therapy for patients with COVID-19 pneumonia: a before-after study. Int J Antimicrob Agents. 2020;56(2):106077.
Bani-Sadr, F., Hentzien, M., Pascard, M., N'Guyen, Y., Servettaz, A., Andreoletti, L., Kanagaratnam, L., & Jolly, D. (2020). Corticosteroid therapy for patients with COVID-19 pneumonia: a before-after study. International Journal of Antimicrobial Agents, 56(2), 106077. https://doi.org/10.1016/j.ijantimicag.2020.106077
Bani-Sadr F, et al. Corticosteroid Therapy for Patients With COVID-19 Pneumonia: a Before-after Study. Int J Antimicrob Agents. 2020;56(2):106077. PubMed PMID: 32634602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Corticosteroid therapy for patients with COVID-19 pneumonia: a before-after study. AU - Bani-Sadr,Firouzé, AU - Hentzien,Maxime, AU - Pascard,Madeline, AU - N'Guyen,Yohan, AU - Servettaz,Amélie, AU - Andreoletti,Laurent, AU - Kanagaratnam,Lukshe, AU - Jolly,Damien, Y1 - 2020/07/04/ PY - 2020/05/13/received PY - 2020/06/16/revised PY - 2020/06/28/accepted PY - 2020/7/8/pubmed PY - 2020/8/22/medline PY - 2020/7/8/entrez KW - COVID-19 KW - COVID-19 pneumonia KW - Corticosteroid KW - SARS-CoV-2 SP - 106077 EP - 106077 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 56 IS - 2 N2 - Anti-inflammatory drugs such as corticosteroids may beneficially modulate the host inflammatory response to coronavirus disease 2019 (COVID-19) pneumonia. The aim of this study was to evaluate the impact of addition of corticosteroids to the hospital protocol for treatment of suspected or confirmed COVID-19 pneumonia on rates of death or intensive care unit (ICU) admission. A before-after study was performed to evaluate the effect of addition of corticosteroids to our institution's COVID-19 treatment protocol on hospital mortality. A total of 257 patients with a COVID-19 diagnosis were included in this study between 3 March 2020 and 14 April 2020. As corticosteroids were widely used after 27 March 2020, two periods were considered for the purposes of this study: the 'before' period from 3-20 March 2020 (n = 85); and the 'after' period from 26 March-14 April 2020 (n = 172). The 'after' period was associated with a lower risk of death [adjusted hazard ratio (aHR) = 0.47, 95% confidence interval (CI) 0.23-0.97; P = 0.04] and a lower risk of ICU admission or of death before ICU admission (aHR = 0.37, 95% CI 0.21-0.64; P = 0.0005) by multivariate analysis adjusted for age, National Early Warning score and institutionalisation status. In conclusion, addition of corticosteroids to our institution's COVID-19 treatment protocol was associated with a significant reduction in hospital mortality in the 'after' period. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/32634602/Corticosteroid_therapy_for_patients_with_COVID_19_pneumonia:_a_before_after_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(20)30247-8 DB - PRIME DP - Unbound Medicine ER -