Background: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality. Methods: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality. Results: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26–0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L). Conclusions: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.

Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19. insights from the cardio-COVID-Italy multicenter study / Pagnesi, M.; Inciardi, R. M.; Lombardi, C. M.; Agostoni, P.; Ameri, P.; Barbieri, L.; Bellasi, A.; Camporotondo, R.; Canale, C.; Carubelli, V.; Carugo, S.; Catagnano, F.; Dalla Vecchia, L. A.; Danzi, G. B.; Di Pasquale, M.; Gaudenzi, M.; Giovinazzo, S.; Gnecchi, M.; Guazzi, M.; Iorio, A.; La Rovere, M. T.; Leonardi, S.; Maccagni, G.; Mapelli, M.; Margonato, D.; Merlo, M.; Monzo, L.; Mortara, A.; Nuzzi, V.; Piepoli, M.; Porto, I.; Pozzi, A.; Sarullo, F.; Sinagra, G.; Tedino, C.; Tomasoni, D.; Volterrani, M.; Zaccone, G.; Senni, M.; Metra, M.. - In: INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES. - ISSN 1201-9712. - 108(2021), pp. 270-273. [10.1016/j.ijid.2021.05.056]

Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19. insights from the cardio-COVID-Italy multicenter study

Monzo L.;
2021

Abstract

Background: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality. Methods: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality. Results: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26–0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L). Conclusions: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1579536
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