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Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia

Corticosteroids have been widely used for acute respiratory distress syndrome (ARDS), but their role in the early phase of SARS-CoV-2 infection is controversial. Our study aimed to determine the effectiveness of early corticosteroid therapy (ECT) in preventing the progression of disease, reducing th...

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Autores principales: Okoye, Chukwuma, Rogani, Sara, Franchi, Riccardo, Pompilii, Igino Maria, Calabrese, Alessia Maria, Mazzarone, Tessa, Bianchi, Elena, Lemmi, Bianca, Calsolaro, Valeria, Monzani, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871955/
https://www.ncbi.nlm.nih.gov/pubmed/35200526
http://dx.doi.org/10.3390/geriatrics7010021
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author Okoye, Chukwuma
Rogani, Sara
Franchi, Riccardo
Pompilii, Igino Maria
Calabrese, Alessia Maria
Mazzarone, Tessa
Bianchi, Elena
Lemmi, Bianca
Calsolaro, Valeria
Monzani, Fabio
author_facet Okoye, Chukwuma
Rogani, Sara
Franchi, Riccardo
Pompilii, Igino Maria
Calabrese, Alessia Maria
Mazzarone, Tessa
Bianchi, Elena
Lemmi, Bianca
Calsolaro, Valeria
Monzani, Fabio
author_sort Okoye, Chukwuma
collection PubMed
description Corticosteroids have been widely used for acute respiratory distress syndrome (ARDS), but their role in the early phase of SARS-CoV-2 infection is controversial. Our study aimed to determine the effectiveness of early corticosteroid therapy (ECT) in preventing the progression of disease, reducing the escalation of care and improving clinical outcome in older patients hospitalized for COVID-19 pneumonia. A total of 90 subjects (47.7% women; mean age = 82.3 ± 6.7 years) were enrolled. ECT was administered to 33 out of 90 patients before the hospitalization. At admission, no difference was detected in median SOFA score (2, IQR:2 vs. 2, IQR: 2). We found a significant difference in mean PaO(2)/FiO(2) ratio during the first week of hospitalization between ECT patients and controls (F = 5.49, p = 0.002) and in mean PaO(2)/FiO(2) ratio over time (F = 6.94, p < 0.0001). We detected no-significant differences in terms of in-hospital mortality and transfer to ICU between ECT patients and controls (27.1% vs. 22.8%, respectively, p = 0.63). ECT was associated with worse clinical outcomes, showing no benefit in attenuating the progression of the disease or reducing the escalation of care. These findings are crucial given the current pandemic, and further studies are needed to provide additional data on the optimal timing of initiating corticosteroid treatment.
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spelling pubmed-88719552022-02-25 Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia Okoye, Chukwuma Rogani, Sara Franchi, Riccardo Pompilii, Igino Maria Calabrese, Alessia Maria Mazzarone, Tessa Bianchi, Elena Lemmi, Bianca Calsolaro, Valeria Monzani, Fabio Geriatrics (Basel) Brief Report Corticosteroids have been widely used for acute respiratory distress syndrome (ARDS), but their role in the early phase of SARS-CoV-2 infection is controversial. Our study aimed to determine the effectiveness of early corticosteroid therapy (ECT) in preventing the progression of disease, reducing the escalation of care and improving clinical outcome in older patients hospitalized for COVID-19 pneumonia. A total of 90 subjects (47.7% women; mean age = 82.3 ± 6.7 years) were enrolled. ECT was administered to 33 out of 90 patients before the hospitalization. At admission, no difference was detected in median SOFA score (2, IQR:2 vs. 2, IQR: 2). We found a significant difference in mean PaO(2)/FiO(2) ratio during the first week of hospitalization between ECT patients and controls (F = 5.49, p = 0.002) and in mean PaO(2)/FiO(2) ratio over time (F = 6.94, p < 0.0001). We detected no-significant differences in terms of in-hospital mortality and transfer to ICU between ECT patients and controls (27.1% vs. 22.8%, respectively, p = 0.63). ECT was associated with worse clinical outcomes, showing no benefit in attenuating the progression of the disease or reducing the escalation of care. These findings are crucial given the current pandemic, and further studies are needed to provide additional data on the optimal timing of initiating corticosteroid treatment. MDPI 2022-02-17 /pmc/articles/PMC8871955/ /pubmed/35200526 http://dx.doi.org/10.3390/geriatrics7010021 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Okoye, Chukwuma
Rogani, Sara
Franchi, Riccardo
Pompilii, Igino Maria
Calabrese, Alessia Maria
Mazzarone, Tessa
Bianchi, Elena
Lemmi, Bianca
Calsolaro, Valeria
Monzani, Fabio
Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title_full Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title_fullStr Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title_full_unstemmed Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title_short Pitfalls of Early Systemic Corticosteroids Home Therapy in Older Patients with COVID-19 Pneumonia
title_sort pitfalls of early systemic corticosteroids home therapy in older patients with covid-19 pneumonia
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871955/
https://www.ncbi.nlm.nih.gov/pubmed/35200526
http://dx.doi.org/10.3390/geriatrics7010021
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