Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19

Objective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. W...

Descripción completa

Detalles Bibliográficos
Autores: Lavilla Olleros, Cristina, Ausín García, Cristina, Bendala Estrada, Alejandro David, Muñoz, Ana, Wikman Jogersen, Philip Erick, Fernández Cruz, Ana, Giner Galvañ, Vicente, Vargas, Juan Antonio, Seguí Ripoll, José Miguel, Rubio Rivas, Manuel, Miranda Godoy, Rodrigo, Mérida Rodrigo, Luis, Fonseca Aizpuru, Eva, Arnalich Fernández, Francisco, Artero, Arturo, Loureiro Amigo, Jose, García García, Gema María, Corral Gudino, Luis, Jiménez Torres, Jose, Casas Rojo, José Manuel, Millán Núñez-Cortés, Jesús, On Behalf of the SEMI-COVID-19 Network
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/187043
Acceso en línea:https://hdl.handle.net/2445/187043
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
Epidemiologia
Corticosteroides
Epidemiology
Adrenocortical hormones
id ES_a2bbddae3f0dbbc08856754956314c8f
oai_identifier_str oai:diposit.ub.edu:2445/187043
network_acronym_str ES
network_name_str España
repository_id_str
spelling Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19Lavilla Olleros, CristinaAusín García, CristinaBendala Estrada, Alejandro DavidMuñoz, AnaWikman Jogersen, Philip ErickFernández Cruz, AnaGiner Galvañ, VicenteVargas, Juan AntonioSeguí Ripoll, José MiguelRubio Rivas, ManuelMiranda Godoy, RodrigoMérida Rodrigo, LuisFonseca Aizpuru, EvaArnalich Fernández, FranciscoArtero, ArturoLoureiro Amigo, JoseGarcía García, Gema MaríaCorral Gudino, LuisJiménez Torres, JoseCasas Rojo, José ManuelMillán Núñez-Cortés, JesúsOn Behalf of the SEMI-COVID-19 NetworkCOVID-19SARS-CoV-2EpidemiologiaCorticosteroidesCOVID-19SARS-CoV-2EpidemiologyAdrenocortical hormonesObjective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses. Results Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, 2,216 (46%) specifically received megadoses. Age was a factor that differed between those who received megadoses therapy versus those who did not in a significant manner (69 years [IQR 59-79] vs 73 years [IQR 61-83]; p < .001). Radiological and analytical findings showed a higher use of megadoses therapy among patients with an interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the univariate study it appears that steroid use is associated with increased mortality (OR 2.07 95% CI 1.91-2.24 p < .001) and megadose use with increased survival (OR 0.84 95% CI 0.75-0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32-1.80; p < .001). There is no difference between megadoses and low-dose (p.298). Although, there are differences in the use of megadoses versus low-dose in terms of complications, mainly infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI 0.71-0.95; p < .001 and OR 0.80 95% CI 0.65-0.97; p < .001) respectively. Conclusion There is no difference in mortality with megadoses versus low-dose, but there is a lower incidence of infectious complications with glucocorticoid megadoses.Public Library of Science (PLoS)2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/187043Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0261711PLOS ONE, 2022, vol. 17, num. 1, p. e0261711https://doi.org/10.1371/journal.pone.0261711cc by (c) Lavilla Olleros, Cristina et al., 2022http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1870432026-05-27T06:46:51Z
dc.title.none.fl_str_mv Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
title Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
spellingShingle Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
Lavilla Olleros, Cristina
COVID-19
SARS-CoV-2
Epidemiologia
Corticosteroides
COVID-19
SARS-CoV-2
Epidemiology
Adrenocortical hormones
title_short Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
title_full Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
title_fullStr Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
title_full_unstemmed Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
title_sort Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
dc.creator.none.fl_str_mv Lavilla Olleros, Cristina
Ausín García, Cristina
Bendala Estrada, Alejandro David
Muñoz, Ana
Wikman Jogersen, Philip Erick
Fernández Cruz, Ana
Giner Galvañ, Vicente
Vargas, Juan Antonio
Seguí Ripoll, José Miguel
Rubio Rivas, Manuel
Miranda Godoy, Rodrigo
Mérida Rodrigo, Luis
Fonseca Aizpuru, Eva
Arnalich Fernández, Francisco
Artero, Arturo
Loureiro Amigo, Jose
García García, Gema María
Corral Gudino, Luis
Jiménez Torres, Jose
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
On Behalf of the SEMI-COVID-19 Network
author Lavilla Olleros, Cristina
author_facet Lavilla Olleros, Cristina
Ausín García, Cristina
Bendala Estrada, Alejandro David
Muñoz, Ana
Wikman Jogersen, Philip Erick
Fernández Cruz, Ana
Giner Galvañ, Vicente
Vargas, Juan Antonio
Seguí Ripoll, José Miguel
Rubio Rivas, Manuel
Miranda Godoy, Rodrigo
Mérida Rodrigo, Luis
Fonseca Aizpuru, Eva
Arnalich Fernández, Francisco
Artero, Arturo
Loureiro Amigo, Jose
García García, Gema María
Corral Gudino, Luis
Jiménez Torres, Jose
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
On Behalf of the SEMI-COVID-19 Network
author_role author
author2 Ausín García, Cristina
Bendala Estrada, Alejandro David
Muñoz, Ana
Wikman Jogersen, Philip Erick
Fernández Cruz, Ana
Giner Galvañ, Vicente
Vargas, Juan Antonio
Seguí Ripoll, José Miguel
Rubio Rivas, Manuel
Miranda Godoy, Rodrigo
Mérida Rodrigo, Luis
Fonseca Aizpuru, Eva
Arnalich Fernández, Francisco
Artero, Arturo
Loureiro Amigo, Jose
García García, Gema María
Corral Gudino, Luis
Jiménez Torres, Jose
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
On Behalf of the SEMI-COVID-19 Network
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
SARS-CoV-2
Epidemiologia
Corticosteroides
COVID-19
SARS-CoV-2
Epidemiology
Adrenocortical hormones
topic COVID-19
SARS-CoV-2
Epidemiologia
Corticosteroides
COVID-19
SARS-CoV-2
Epidemiology
Adrenocortical hormones
description Objective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses. Results Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, 2,216 (46%) specifically received megadoses. Age was a factor that differed between those who received megadoses therapy versus those who did not in a significant manner (69 years [IQR 59-79] vs 73 years [IQR 61-83]; p < .001). Radiological and analytical findings showed a higher use of megadoses therapy among patients with an interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the univariate study it appears that steroid use is associated with increased mortality (OR 2.07 95% CI 1.91-2.24 p < .001) and megadose use with increased survival (OR 0.84 95% CI 0.75-0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32-1.80; p < .001). There is no difference between megadoses and low-dose (p.298). Although, there are differences in the use of megadoses versus low-dose in terms of complications, mainly infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI 0.71-0.95; p < .001 and OR 0.80 95% CI 0.65-0.97; p < .001) respectively. Conclusion There is no difference in mortality with megadoses versus low-dose, but there is a lower incidence of infectious complications with glucocorticoid megadoses.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/187043
url https://hdl.handle.net/2445/187043
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0261711
PLOS ONE, 2022, vol. 17, num. 1, p. e0261711
https://doi.org/10.1371/journal.pone.0261711
dc.rights.none.fl_str_mv cc by (c) Lavilla Olleros, Cristina et al., 2022
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Lavilla Olleros, Cristina et al., 2022
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869415322062159872
score 15,300724

Similares en LA Referencia