Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype.

Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype. Chest. 2020 Dec 11;: Authors: Chen H, Xie J, Su N, Wang J, Sun Q, Li S, Jin J, Zhou J, Mo M, Wei Y, Chao Y, Hu W, Du B, Qiu H Abstract BACKGROUND: Corticosteroid therapy is commonly used in patients with coronavirus disease 2019 (COVID-19), while its impact on outcomes and which patients could benefit from corticosteroid therapy are uncertain. RESEARCH QUESTION: Whether clinical phenotypes of COVID-19 were associated with differential response to corticosteroid therapy. STUDY DESIGN AND METHODS: Critically ill patients with COVID-19 from Tongji hospital between Jan 2020 and Feb 2020 were included, and the main exposure of interest was the administration of intravenous corticosteroids. The primary outcome was 28-day mortality. Marginal structural modeling was used to account for baseline and time-dependent confounders. An unsupervised machine learning approach was carried out to identify phenotypes of COVID-19. RESULTS: A total of 428 patients were included, and 280/428 (65.4%) patients received corticosteroid therapy. The 28-day mortality was significantly higher in patients who received corticosteroid therapy than in those who did not (53.9% vs. 19.6%; p<0.0001). After marginal structural modeling, corticosteroid therapy was not significantly associated with 28-day mortality (HR ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research