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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Wang, Wenjuan Snell, Luke B Ferrari, Davide Goodman, Anna L Price, Nicholas M Wolfe, Charles D Curcin, Vasa Edgeworth, Jonathan D Wang, Yanzhong |
| Abstract | Introduction Randomised controlled trials have shown that steroids reduce the risk of dying in patients with severe Coronavirus disease 2019 (COVID-19), whilst many real-world studies have failed to replicate this result. We aim to investigate real-world effectiveness of steroids in severe COVID-19. Methods Clinical, demographic, and viral genome data extracted from electronic patient record (EPR) was analysed from all SARS-CoV-2 RNA positive patients admitted with severe COVID-19, defined by hypoxia at presentation, between March 13th 2020 and May 27th 2021. Steroid treatment was measured by the number of prescription-days with dexamethasone, hydrocortisone, prednisolone or methylprednisolone. The association between steroid > 3 days treatment and disease outcome was explored using multivariable cox proportional hazards models with adjustment for confounders (including age, gender, ethnicity, co-morbidities and SARS-CoV-2 variant). The outcome was in-hospital mortality. Results 1100 severe COVID-19 cases were identified having crude hospital mortality of 15.3%. 793/1100 (72.1%) individuals were treated with steroids and 513/1100 (46.6%) received steroid ≤ 3 days. From the multivariate model, steroid > 3 days was associated with decreased hazard of in-hospital mortality (HR: 0.47 (95% CI: 0.31–0.72)). Conclusion The protective effect of steroid treatment for severe COVID-19 reported in randomised clinical trials was replicated in this retrospective study of a large real-world cohort. |
| Related Links | https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-022-07750-3.pdf |
| Ending Page | 7 |
| Page Count | 7 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712334 |
| DOI | 10.1186/s12879-022-07750-3 |
| Journal | BMC Infectious Diseases |
| Issue Number | 1 |
| Volume Number | 22 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-10-05 |
| Access Restriction | Open |
| Subject Keyword | Infectious Diseases Parasitology Medical Microbiology Tropical Medicine Internal Medicine COVID-19 Steroids Mortality Retrospective cohort study |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases |
| Journal Impact Factor | 3.4/2023 |
| 5-Year Journal Impact Factor | 3.3/2023 |
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