# name
Effect of Corticosteroids on C-Reactive Protein in Patients with Severe Community-Acquired Pneumonia and High Inflammatory Response: The Effect of Lymphopenia

# metadata.dc.description.abstract[].value
Background: Lymphopenic patients with community-acquired pneumonia (CAP) have
shown high mortality rates. Corticosteroids have immunomodulatory properties and regulate
cytokine storm in CAP. However, it is not known whether their modulatory effect on cytokine
secretion differs in lymphopenic and non-lymphopenic patients with CAP. Therefore, we aimed to test
whether the presence of lymphopenia may modify the response to corticosteroids (mainly in C reactive
protein (CRP)) in patients with severe CAP and high inflammatory status). Methods: A post hoc
analysis of a randomized controlled trial (NCT00908713) which evaluated the effect of corticosteroids in
patients with severe CAP and high inflammatory response (CRP > 15 mg/dL). Patients were clustered
according to the presence of lymphopenia (lymphocyte count below 1000 cell/mm3
). Results: At day
1, 35 patients (59%) in the placebo group presented with lymphopenia, compared to 44 patients (73%)
in the corticosteroid group. The adjusted mean changes from day 1 showed an increase of 1.19 natural
logarithm (ln) cell/mm3
in the corticosteroid group and an increase of 0.67 ln cell/mm3
in the placebo
group (LS mean difference of the changes in ln (methylprednisolone minus placebo) 0.51, 95% CI
(0.02 to 1.01), p = 0.043). A significant effect was also found for the interaction (p = 0.043) between
corticosteroids and lymphopenia in CRP values at day 3, with lower values in patients without
lymphopenia receiving corticosteroids after adjustments for potential confounders. Conclusion:
In this exploratory post hoc analysis from ramdomized controlled trial (RCT) data, the response to
corticosteroids, measured by CRP, may differ according to lymphocyte count. Further larger studies
are needed to confirm this data.

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Journal of Clinical Medicine, 2019, vol. 8, num. 9, p. 1461

# metadata.dc.source[].value
Articles publicats en revistes (Medicina)

# metadata.dc.title[].value
Effect of Corticosteroids on C-Reactive Protein in Patients with Severe Community-Acquired Pneumonia and High Inflammatory Response: The Effect of Lymphopenia