Common blood test identifies benefits and risks of steroid t
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A cheap and easy blood test for inflammation may help determine which COVID-19 patients will benefit from getting steroids.

In an observational study of people hospitalized with COVID-19, those with high levels of an inflammation indicator called C-reactive protein in their blood had a reduced chance of dying or being put on a ventilator when treated with steroids. But steroid treatment more than doubled the risk of needing a ventilator or dying for people with low levels of the inflammation-indicating protein, researchers report in the Journal of Hospital Medicine.

The new results are in line with those from the RECOVERY trial and may help explain why some patients do better on steroids than others, researchers say.

Among 1,806 patients in the study admitted to Montefiore’s four hospitals were prescribed steroids. In 198 patients with levels of C-reactive protein of 20 milligrams per deciliter of blood or higher, steroid use reduced the chance of going a ventilator or dying by 77 percent, compared with those not taking the drugs. But in people whose C-reactive protein levels were 10mg/dL or lower, steroids increased the chance of death or ventilation by 2.64 to 3.14 times compared with those not taking the drug.

“Steroids are not appropriate for all. It’s just as important to avoid giving steroids to the people who may be harmed as it is to give steroids that may benefit,” Southern says.

The researchers plan to use data collected in this study to determine whether tracking levels of C-reactive protein can also predict whether patients are recovering.

Source: https://www.journalofhospitalmedicine.com/jhospmed/article/225402/hospital-medicine/effect-systemic-glucocorticoids-mortality-or-mechanical
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