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http://hdl.handle.net/2445/186219
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DC Field | Value | Language |
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dc.contributor.author | Monedero, Pablo | - |
dc.contributor.author | Gea, Alfredo | - |
dc.contributor.author | Castro Rebollo, Pedro | - |
dc.contributor.author | Candela Toha, Angel M. | - |
dc.contributor.author | Hernández Sanz, María L. | - |
dc.contributor.author | Arruti, Egoitz | - |
dc.contributor.author | Villar, Jesús | - |
dc.contributor.author | Ferrando, Carlos | - |
dc.contributor.author | COVID-19 Spanish ICU Network | - |
dc.date.accessioned | 2022-06-01T16:39:50Z | - |
dc.date.available | 2022-06-01T16:39:50Z | - |
dc.date.issued | 2021-01-04 | - |
dc.identifier.issn | 1364-8535 | - |
dc.identifier.uri | http://hdl.handle.net/2445/186219 | - |
dc.description.abstract | Background: Critically ill patients with coronavirus disease 19 (COVID-19) have a high fatality rate likely due to a dysregulated immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose. Methods: This is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from 12th March to 29th June 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the frst 48 h of ICU admission) with those who did not receive early corticosteroids (delayed group) or any corticosteroids at all (never group). Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications. Results: A total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n=485) had lower ICU mortality (30.3% vs. never 36.6% and delayed 44.2%) and lower 7-day mortality (7.2% vs. never 15.2%) compared to non-early treated patients. They also had higher number of ventilator-free days, less length of ICU stay, and less secondary infections than delayed treated patients. There were no diferences in medical complications between groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens. Conclusion: Early use of corticosteroids in critically ill patients with COVID-19 is associated with lower mortality than no or delayed use, and fewer complications than delayed use. Keywords: COVID-19, Intensive Care Unit, Corticosteroids, Critically ill patient, Cohort study, Outcomes, Ventilatorfree days, Mortality | - |
dc.format.extent | 13 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | BioMed Central | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1186/s13054-020-03422-3 | - |
dc.relation.ispartof | Critical Care, 2021, vol. 25, num. 1, p. 2 | - |
dc.relation.uri | https://doi.org/10.1186/s13054-020-03422-3 | - |
dc.rights | cc-by (c) Monedero, Pablo et al., 2021 | - |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | - |
dc.source | Articles publicats en revistes (Medicina) | - |
dc.subject.classification | COVID-19 | - |
dc.subject.classification | Malalts en estat crític | - |
dc.subject.classification | Resposta immunitària | - |
dc.subject.classification | Inflamació | - |
dc.subject.classification | Corticosteroides | - |
dc.subject.classification | Assaigs clínics | - |
dc.subject.classification | Mortalitat | - |
dc.subject.other | COVID-19 | - |
dc.subject.other | Critically ill | - |
dc.subject.other | Immune response | - |
dc.subject.other | Inflammation | - |
dc.subject.other | Adrenocortical hormones | - |
dc.subject.other | Clinical trials | - |
dc.subject.other | Mortality | - |
dc.title | Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19: a cohort study | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 718904 | - |
dc.date.updated | 2022-06-01T16:39:50Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 33397463 | - |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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718904.pdf | 1.28 MB | Adobe PDF | View/Open |
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