PMID- 32571831
OWN - NLM
STAT- MEDLINE
DCOM- 20200902
LR  - 20240329
IS  - 1098-6596 (Electronic)
IS  - 0066-4804 (Print)
IS  - 0066-4804 (Linking)
VI  - 64
IP  - 9
DP  - 2020 Aug 20
TI  - A Retrospective Controlled Cohort Study of the Impact of Glucocorticoid Treatment 
      in SARS-CoV-2 Infection Mortality.
LID - 10.1128/AAC.01168-20 [doi]
LID - e01168-20
AB  - Evidence to support the use of steroids in coronavirus disease 2019 (COVID-19) 
      pneumonia is lacking. We aim to determine the impact of steroid use for COVID-19 
      pneumonia on hospital mortality. We performed a single-center retrospective 
      cohort study in a university hospital in Madrid, Spain, during March of 2020. To 
      determine the role of steroids in in-hospital mortality, patients admitted with 
      severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia and 
      treated with steroids were compared to patients not treated with steroids, and we 
      adjusted with a propensity score for patients on steroid treatment. Survival 
      times were compared using the log rank test. Different steroid regimens were 
      compared and adjusted with a second propensity score. During the study period, 
      463 out of 848 hospitalized patients with COVID-19 pneumonia fulfilled inclusion 
      criteria. Among them, 396 (46.7%) patients were treated with steroids and 67 
      patients were not. Global mortality was 15.1%. The median time to steroid 
      treatment from symptom onset was 10 days (interquartile range [IQR], 8 to 13 
      days). In-hospital mortality was lower in patients treated with steroids than in 
      controls (13.9% [55/396] versus 23.9% [16/67]; hazard ratio [HR], 0.51 [95% 
      confidence interval, 0.27 to 0.96]; P = 0.044). Steroid treatment reduced 
      mortality by 41.8% relative to the mortality with no steroid treatment (relative 
      risk reduction, 0.42 [95% confidence interval, 0.048 to 0.65]). Initial treatment 
      with 1 mg/kg of body weight/day of methylprednisolone versus steroid pulses was 
      not associated with in-hospital mortality (13.5% [42/310] versus 15.1% [13/86]; 
      odds ratio [OR], 0.880 [95% confidence interval, 0.449 to 1.726]; P = 0.710). Our 
      results show that the survival of patients with SARS-CoV-2 pneumonia is higher in 
      patients treated with glucocorticoids than in those not treated. Rates of 
      in-hospital mortality were not different between initial regimens of 1 mg/kg/day 
      of methylprednisolone and glucocorticoid pulses.
CI  - Copyright (c) 2020 Fernandez-Cruz et al.
FAU - Fernandez-Cruz, Ana
AU  - Fernandez-Cruz A
AUID- ORCID: 0000-0003-1189-1120
AD  - Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 
      Puerta de Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de 
      Hierro-Segovia de Arana, Madrid, Spain anafcruz999@gmail.com.
FAU - Ruiz-Antoran, Belen
AU  - Ruiz-Antoran B
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Munoz-Gomez, Ana
AU  - Munoz-Gomez A
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Sancho-Lopez, Aranzazu
AU  - Sancho-Lopez A
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Mills-Sanchez, Patricia
AU  - Mills-Sanchez P
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Centeno-Soto, Gustavo Adolfo
AU  - Centeno-Soto GA
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Blanco-Alonso, Silvia
AU  - Blanco-Alonso S
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Javaloyes-Garachana, Laura
AU  - Javaloyes-Garachana L
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Galan-Gomez, Amy
AU  - Galan-Gomez A
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Valencia-Alijo, Angela
AU  - Valencia-Alijo A
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Gomez-Irusta, Javier
AU  - Gomez-Irusta J
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Payares-Herrera, Concepcion
AU  - Payares-Herrera C
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Morras-Torre, Ignacio
AU  - Morras-Torre I
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Sanchez-Chica, Enrique
AU  - Sanchez-Chica E
AD  - Internal Medicine Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
FAU - Delgado-Tellez-de-Cepeda, Laura
AU  - Delgado-Tellez-de-Cepeda L
AD  - Pharmacy Department, Hospital Universitario Puerta de Hierro-Majadahonda, 
      Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia de Arana, Madrid, 
      Spain.
FAU - Callejas-Diaz, Alejandro
AU  - Callejas-Diaz A
AD  - Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 
      Puerta de Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de 
      Hierro-Segovia de Arana, Madrid, Spain.
FAU - Ramos-Martinez, Antonio
AU  - Ramos-Martinez A
AUID- ORCID: 0000-0002-4840-9425
AD  - Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 
      Puerta de Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de 
      Hierro-Segovia de Arana, Madrid, Spain.
AD  - Pharmacy Department, Hospital Universitario Puerta de Hierro-Majadahonda, 
      Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia de Arana, Madrid, 
      Spain.
AD  - Medicine Department, School of Medicine, Universidad Autonoma de Madrid, Madrid, 
      Spain.
FAU - Munez-Rubio, Elena
AU  - Munez-Rubio E
AD  - Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 
      Puerta de Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de 
      Hierro-Segovia de Arana, Madrid, Spain.
FAU - Avendano-Sola, Cristina
AU  - Avendano-Sola C
AD  - Clinical Pharmacology Department, Hospital Universitario Puerta de 
      Hierro-Majadahonda, Instituto de Investigacion Sanitaria Puerta de Hierro-Segovia 
      de Arana, Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20200820
PL  - United States
TA  - Antimicrob Agents Chemother
JT  - Antimicrobial agents and chemotherapy
JID - 0315061
RN  - 0 (Antiviral Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (lopinavir-ritonavir drug combination)
RN  - 2494G1JF75 (Lopinavir)
RN  - 4QWG6N8QKH (Hydroxychloroquine)
RN  - 83905-01-5 (Azithromycin)
RN  - 9008-11-1 (Interferons)
RN  - O3J8G9O825 (Ritonavir)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Aged
MH  - Antiviral Agents/*therapeutic use
MH  - Azithromycin/*therapeutic use
MH  - Betacoronavirus/*drug effects/immunology/pathogenicity
MH  - COVID-19
MH  - Cardiovascular Diseases/drug therapy/immunology/mortality/virology
MH  - Comorbidity
MH  - Coronavirus Infections/*drug therapy/immunology/mortality/virology
MH  - Diabetes Mellitus/drug therapy/immunology/mortality/virology
MH  - Drug Administration Schedule
MH  - Drug Combinations
MH  - Drug Therapy, Combination
MH  - Dyslipidemias/drug therapy/immunology/mortality/virology
MH  - Female
MH  - Hospitals, University
MH  - Humans
MH  - Hydroxychloroquine/*therapeutic use
MH  - Intensive Care Units
MH  - Interferons/*therapeutic use
MH  - Length of Stay/statistics & numerical data
MH  - Lopinavir/*therapeutic use
MH  - Male
MH  - Methylprednisolone/*therapeutic use
MH  - Middle Aged
MH  - Neoplasms/drug therapy/immunology/mortality/virology
MH  - Pandemics
MH  - Pneumonia, Viral/*drug therapy/immunology/mortality/virology
MH  - Retrospective Studies
MH  - Ritonavir/*therapeutic use
MH  - SARS-CoV-2
MH  - Survival Analysis
PMC - PMC7449182
OTO - NOTNLM
OT  - COVID-19
OT  - mortality
OT  - steroids
EDAT- 2020/06/24 06:00
MHDA- 2020/09/04 06:00
PMCR- 2020/08/20
CRDT- 2020/06/24 06:00
PHST- 2020/06/08 00:00 [received]
PHST- 2020/06/19 00:00 [accepted]
PHST- 2020/06/24 06:00 [pubmed]
PHST- 2020/09/04 06:00 [medline]
PHST- 2020/06/24 06:00 [entrez]
PHST- 2020/08/20 00:00 [pmc-release]
AID - AAC.01168-20 [pii]
AID - 01168-20 [pii]
AID - 10.1128/AAC.01168-20 [doi]
PST - epublish
SO  - Antimicrob Agents Chemother. 2020 Aug 20;64(9):e01168-20. doi: 
      10.1128/AAC.01168-20. Print 2020 Aug 20.