Cargando…
The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia
BACKGROUND: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. METHO...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Academy of Tuberculosis and Respiratory Diseases
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273022/ https://www.ncbi.nlm.nih.gov/pubmed/34078038 http://dx.doi.org/10.4046/trd.2021.0009 |
_version_ | 1783721299154042880 |
---|---|
author | Lee, Hyun Woo Park, Jimyung Lee, Jung-Kyu Park, Tae Yeon Heo, Eun Young |
author_facet | Lee, Hyun Woo Park, Jimyung Lee, Jung-Kyu Park, Tae Yeon Heo, Eun Young |
author_sort | Lee, Hyun Woo |
collection | PubMed |
description | BACKGROUND: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. METHODS: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO(2) <90%. RESULTS: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. CONCLUSION: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality. |
format | Online Article Text |
id | pubmed-8273022 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
record_format | MEDLINE/PubMed |
spelling | pubmed-82730222021-07-26 The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia Lee, Hyun Woo Park, Jimyung Lee, Jung-Kyu Park, Tae Yeon Heo, Eun Young Tuberc Respir Dis (Seoul) Original Article BACKGROUND: Despite the proven benefits of dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients, the optimum time for the administration of dexamethasone is unknown. We investigated the progression of COVID-19 pneumonia based on the timing of dexamethasone administration. METHODS: A single-center, retrospective cohort study based on medical record reviews was conducted between June 10 and September 21, 2020. We compared the risk of severe COVID-19, defined as the use of a high-flow nasal cannula or a mechanical ventilator, between groups that received dexamethasone either within 24 hours of hypoxemia (early dexamethasone group) or 24 hours after hypoxemia (late dexamethasone group). Hypoxemia was defined as room-air SpO(2) <90%. RESULTS: Among 59 patients treated with dexamethasone for COVID-19 pneumonia, 30 were in the early dexamethasone group and 29 were in the late dexamethasone group. There was no significant difference in baseline characteristics, the time interval from symptom onset to diagnosis or hospitalization, or the use of antiviral or antibacterial agents between the two groups. The early dexamethasone group showed a significantly lower rate of severe COVID-19 compared to the control group (75.9% vs. 40.0%, p=0.012). Further, the early dexamethasone group showed a significantly shorter total duration of oxygen supplementation (10.45 days vs. 21.61 days, p=0.003) and length of stay in the hospital (19.76 days vs. 27.21 days, p=0.013). However, extracorporeal membrane oxygenation and in-hospital mortality rates were not significantly different between the two groups. CONCLUSION: Early administration of dexamethasone may prevent the progression of COVID-19 to a severe disease, without increased mortality. The Korean Academy of Tuberculosis and Respiratory Diseases 2021-07 2021-03-29 /pmc/articles/PMC8273022/ /pubmed/34078038 http://dx.doi.org/10.4046/trd.2021.0009 Text en Copyright © 2021 The Korean Academy of Tuberculosis and Respiratory Diseases https://creativecommons.org/licenses/by-nc/4.0/It is identical to the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ). |
spellingShingle | Original Article Lee, Hyun Woo Park, Jimyung Lee, Jung-Kyu Park, Tae Yeon Heo, Eun Young The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title | The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title_full | The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title_fullStr | The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title_full_unstemmed | The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title_short | The Effect of the Timing of Dexamethasone Administration in Patients with COVID-19 Pneumonia |
title_sort | effect of the timing of dexamethasone administration in patients with covid-19 pneumonia |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273022/ https://www.ncbi.nlm.nih.gov/pubmed/34078038 http://dx.doi.org/10.4046/trd.2021.0009 |
work_keys_str_mv | AT leehyunwoo theeffectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT parkjimyung theeffectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT leejungkyu theeffectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT parktaeyeon theeffectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT heoeunyoung theeffectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT leehyunwoo effectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT parkjimyung effectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT leejungkyu effectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT parktaeyeon effectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia AT heoeunyoung effectofthetimingofdexamethasoneadministrationinpatientswithcovid19pneumonia |