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Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19
SARS-CoV-2 infection can induce a broad range of clinical symptoms, and the most severe cases are characterized by an uncontrolled inflammatory response with the overproduction of proinflammatory cytokines. Elevated levels of C-reactive protein, interleukin-1B, and interleukin-6 have become key sign...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697502/ https://www.ncbi.nlm.nih.gov/pubmed/36431059 http://dx.doi.org/10.3390/life12111924 |
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author | Scialò, Filippo Mariniello, Domenica Francesca Nigro, Ersilia Komici, Klara Allocca, Valentino Bianco, Andrea Perrotta, Fabio D’Agnano, Vito |
author_facet | Scialò, Filippo Mariniello, Domenica Francesca Nigro, Ersilia Komici, Klara Allocca, Valentino Bianco, Andrea Perrotta, Fabio D’Agnano, Vito |
author_sort | Scialò, Filippo |
collection | PubMed |
description | SARS-CoV-2 infection can induce a broad range of clinical symptoms, and the most severe cases are characterized by an uncontrolled inflammatory response with the overproduction of proinflammatory cytokines. Elevated levels of C-reactive protein, interleukin-1B, and interleukin-6 have become key signatures of severe COVID-19. For this reason, the use of 6 mg of dexamethasone has become a standard of care, although this regime may not be optimal. Even though various glucocorticoid doses have been proposed, it is still unclear which dose should be used to prevent adverse effects while at the same time reducing the inflammatory response. Here, we compared two different doses of corticosteroids in 52 elderly hospitalized patients with severe to critical COVID-19 to assess efficacy and safety. We showed that in patients receiving a higher dose of prednisone, the time to negative swab was significantly longer. Furthermore, although neither dose was correlated with the risk of death, patients receiving the high dose were more likely to have adverse events such as hyperglycemia, leukocytosis, an increase in systemic blood pressure, and others. Finally, the BMI, WBC number, and NLR value were directly related to death. In conclusion, although the optimal glucocorticoid dose is still undefined, our retrospective study supports the absence of beneficial effects in the utilization of higher doses of corticosteroids in elderly patients with severe to critical COVID-19. |
format | Online Article Text |
id | pubmed-9697502 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96975022022-11-26 Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 Scialò, Filippo Mariniello, Domenica Francesca Nigro, Ersilia Komici, Klara Allocca, Valentino Bianco, Andrea Perrotta, Fabio D’Agnano, Vito Life (Basel) Article SARS-CoV-2 infection can induce a broad range of clinical symptoms, and the most severe cases are characterized by an uncontrolled inflammatory response with the overproduction of proinflammatory cytokines. Elevated levels of C-reactive protein, interleukin-1B, and interleukin-6 have become key signatures of severe COVID-19. For this reason, the use of 6 mg of dexamethasone has become a standard of care, although this regime may not be optimal. Even though various glucocorticoid doses have been proposed, it is still unclear which dose should be used to prevent adverse effects while at the same time reducing the inflammatory response. Here, we compared two different doses of corticosteroids in 52 elderly hospitalized patients with severe to critical COVID-19 to assess efficacy and safety. We showed that in patients receiving a higher dose of prednisone, the time to negative swab was significantly longer. Furthermore, although neither dose was correlated with the risk of death, patients receiving the high dose were more likely to have adverse events such as hyperglycemia, leukocytosis, an increase in systemic blood pressure, and others. Finally, the BMI, WBC number, and NLR value were directly related to death. In conclusion, although the optimal glucocorticoid dose is still undefined, our retrospective study supports the absence of beneficial effects in the utilization of higher doses of corticosteroids in elderly patients with severe to critical COVID-19. MDPI 2022-11-18 /pmc/articles/PMC9697502/ /pubmed/36431059 http://dx.doi.org/10.3390/life12111924 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 | Article Scialò, Filippo Mariniello, Domenica Francesca Nigro, Ersilia Komici, Klara Allocca, Valentino Bianco, Andrea Perrotta, Fabio D’Agnano, Vito Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title | Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title_full | Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title_fullStr | Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title_full_unstemmed | Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title_short | Effects of Different Corticosteroid Doses in Elderly Unvaccinated Patients with Severe to Critical COVID-19 |
title_sort | effects of different corticosteroid doses in elderly unvaccinated patients with severe to critical covid-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697502/ https://www.ncbi.nlm.nih.gov/pubmed/36431059 http://dx.doi.org/10.3390/life12111924 |
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