Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA registry
The optimal treatment strategies for hematological malignancy patients with COVID19 are still unclear with respect to the selection and timing of anti-viral as well as anti-inflammatory therapies. Most COVID-19 management recommendations have been adapted from the ones used in immunocompetent patien...
| Autores: | , , , , , , , |
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2024 |
| País: | España |
| Recursos: | Universidad de Sevilla (US) |
| Repositório: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/175614 |
| Acesso em linha: | https://hdl.handle.net/11441/175614 https://doi.org/10.3324/haematol.2023.284678 |
| Access Level: | Acceso aberto |
| Palavra-chave: | COVID19 Hematological malignancy Anti-inflammatory therapies Immunosuppressed patients Dexamethasone treatment SARS-CoV-2 infection Vaccines |
| Resumo: | The optimal treatment strategies for hematological malignancy patients with COVID19 are still unclear with respect to the selection and timing of anti-viral as well as anti-inflammatory therapies. Most COVID-19 management recommendations have been adapted from the ones used in immunocompetent patients. However, immunosuppressed patients often have substantial alterations in their adaptive and innate immunity that affect the pathophysiology of SARS-CoV-2 infection and often have reduced anti-viral immunity as well as dysfunctional inflammatory response. As a result, we hypothesize that these patients mainly benefit more from antiviral treatment, whereas dexamethasone may perpetuate the intrinsic immunosuppression and be even detrimental. Our study demonstrates that dexamethasone treatment for SARS-CoV-2 infection is related to increased mortality in hematological malignancy patients, even during the omicron wave with most patients being fully vaccinated. |
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