Efficacy of corticosteroids in non-intensive care unit patie
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The role of systemic corticosteroid as a therapeutic agent for patients with COVID-19 pneumonia is controversial. This study aimed to evaluate the effect of corticosteroids in non-intensive care unit (ICU) patients with COVID-19 pneumonia complicated by acute hypoxemic respiratory failure (AHRF)

In this single-center retrospective cohort study, 265 patients consecutively admitted to the non-ICU wards with laboratory-confirmed COVID-19 pneumonia were screened for inclusion. 205 patients who developed AHRF were only included in the final study.

Patients were divided into two cohorts based on corticosteroid. The primary outcome was a composite of ICU transfer, intubation, or in-hospital mortality. Secondary outcomes were ICU transfer, intubation, in-hospital mortality, discharge, length of stay, and daily trend of SpO2/FiO2 (SF) ratio from the index date.

Results:
-- Among 205 patients, 60 were treated with corticosteroid.
-- The mean age was 57 years, and 75% were men.
-- Thirteen patients developed a primary composite outcome in the corticosteroid cohort vs. 54 patients in the non-corticosteroid cohort.
-- The adjusted hazard ratio (HR) for the development of the composite primary outcome was 0.15.
-- The adjusted hazard ratio for ICU transfer was 0.16, intubation was 0.31, death was 0.53, composite of death or intubation was 0.31 and discharge was 3.65.
-- The corticosteroid cohort had increasing SpO2/FiO2 over time compared to the non-corticosteroid cohort who experience decreasing SpO2/FiO2 over time.

Conclusively, Among non-ICU patients hospitalized with COVID-19 pneumonia complicated by AHRF, treatment with corticosteroid was associated with a significantly lower risk of the primary composite outcome of ICU transfer, intubation, or in-hospital death, composite of intubation or death and individual components of the primary outcome.

Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238827
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