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Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2

INTRODUCTION: Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are co...

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Autores principales: Callejas Rubio, José Luis, Luna del Castillo, Juan de Dios, de la Hera Fernández, Javier, Guirao Arrabal, Emilio, Colmenero Ruiz, Manuel, Ortego Centeno, Norberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier España, S.L.U. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250763/
https://www.ncbi.nlm.nih.gov/pubmed/32532461
http://dx.doi.org/10.1016/j.medcli.2020.04.018
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author Callejas Rubio, José Luis
Luna del Castillo, Juan de Dios
de la Hera Fernández, Javier
Guirao Arrabal, Emilio
Colmenero Ruiz, Manuel
Ortego Centeno, Norberto
author_facet Callejas Rubio, José Luis
Luna del Castillo, Juan de Dios
de la Hera Fernández, Javier
Guirao Arrabal, Emilio
Colmenero Ruiz, Manuel
Ortego Centeno, Norberto
author_sort Callejas Rubio, José Luis
collection PubMed
description INTRODUCTION: Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids. Our objective is to evaluate the efficacy of GC in the CSS by COVID-19. PATIENTS: We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. We determine CSS markers. We evaluated mortality, intubation, and a combined variable. RESULTS: In all cases the percentages of events were lower in the group of patients with GC was administered. The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival. DISCUSSION: The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death.
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spelling pubmed-72507632020-05-27 Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2 Callejas Rubio, José Luis Luna del Castillo, Juan de Dios de la Hera Fernández, Javier Guirao Arrabal, Emilio Colmenero Ruiz, Manuel Ortego Centeno, Norberto Med Clin (Barc) Article INTRODUCTION: Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids. Our objective is to evaluate the efficacy of GC in the CSS by COVID-19. PATIENTS: We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. We determine CSS markers. We evaluated mortality, intubation, and a combined variable. RESULTS: In all cases the percentages of events were lower in the group of patients with GC was administered. The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival. DISCUSSION: The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death. Elsevier España, S.L.U. 2020-08-28 2020-05-27 /pmc/articles/PMC7250763/ /pubmed/32532461 http://dx.doi.org/10.1016/j.medcli.2020.04.018 Text en © 2020 Elsevier España, S.L.U. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Callejas Rubio, José Luis
Luna del Castillo, Juan de Dios
de la Hera Fernández, Javier
Guirao Arrabal, Emilio
Colmenero Ruiz, Manuel
Ortego Centeno, Norberto
Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title_full Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title_fullStr Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title_full_unstemmed Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title_short Eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por SARS-CoV-2
title_sort eficacia de los pulsos de corticoides en pacientes con síndrome de liberación de citocinas inducido por infección por sars-cov-2
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250763/
https://www.ncbi.nlm.nih.gov/pubmed/32532461
http://dx.doi.org/10.1016/j.medcli.2020.04.018
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