COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome
To assess the impact of corticosteroids on inflammatory and respiratory parameters of patients with COVID-19 and acute respiratory distress syndrome (ARDS). Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Ba...
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| Veröffentlicht in: | Revista española de quimioterapia 2021-02, Vol.34 (1), p.33-43 |
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| creator | Vidal-Cortés, P Del Río-Carbajo, L Nieto-Del Olmo, J Prol-Silva, E Tizón-Varela, A I Rodríguez-Vázquez, A Rodríguez-Rodríguez, P Díaz-López, M D Fernández-Ugidos, P Pérez-Veloso, M A |
| description | To assess the impact of corticosteroids on inflammatory and respiratory parameters of patients with COVID-19 and acute respiratory distress syndrome (ARDS).
Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Baseline characteristics, data on SARS-CoV-2 infection, treatment received, evolution of respiratory and inflammatory parameters, and ICU and hospital stay and mortality were analyzed.
A total of 27 patients were included, 63% men, median age: 68.4 (51.8, 72.2) years. All patients met ARDS criteria and received MV and corticosteroids. After corticosteroids treatment we observed a reduction in the O2 A-a gradient [day 0: 322 (249, 425); day 3: 169 (129.5, 239.5) p |
| doi_str_mv | 10.37201/req/091.2020 |
| format | Article |
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Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Baseline characteristics, data on SARS-CoV-2 infection, treatment received, evolution of respiratory and inflammatory parameters, and ICU and hospital stay and mortality were analyzed.
A total of 27 patients were included, 63% men, median age: 68.4 (51.8, 72.2) years. All patients met ARDS criteria and received MV and corticosteroids. After corticosteroids treatment we observed a reduction in the O2 A-a gradient [day 0: 322 (249, 425); day 3: 169 (129.5, 239.5) p<0.001; day 5: 144 (127.5, 228.0) p<0.001; day 7: 192 (120, 261) p=0.002] and an increase in the pO2/FiO2 ratio on days 3 and 5, but not on day 7 [day 0: 129 (100, 168); day 3: 193 (140, 236) p=0.002; day 5: 183 (141, 255) p=0.004; day 7: 170 (116, 251) p=0.057]. CRP also decreased on days 3 and 5 and increased again on day 7 [day 0: 16 (8.6, 24); day 3: 3.4 (1.7, 10.2) p<0.001; day 5: 4.1 (1.4, 10.2) p<0.001; day 7: 13.5 (6.8, 17.3) p=0.063]. Persistence of moderate ARDS on day 7 was related to a greater risk of poor outcome (OR 6.417 [1.091-37.735], p=0.040).
Corticosteroids appears to reduce the inflammation and temporarily improve the oxygenation in COVID-19 and ARDS patients. Persistence of ARDS after 7 days treatment is a predictor of poor outcome.</description><identifier>ISSN: 0214-3429</identifier><identifier>ISSN: 1988-9518</identifier><identifier>EISSN: 1988-9518</identifier><identifier>DOI: 10.37201/req/091.2020</identifier><identifier>PMID: 33317261</identifier><language>eng</language><publisher>Spain: Sociedad Española de Quimioterapia</publisher><subject>Aged ; COVID-19 - metabolism ; COVID-19 Drug Treatment ; Female ; Humans ; Intensive Care Units ; Longitudinal Studies ; Male ; Middle Aged ; Original ; Oxygen Consumption - drug effects ; Oxygen Consumption - physiology ; Respiration, Artificial ; Respiratory Distress Syndrome - drug therapy ; Respiratory Distress Syndrome - metabolism ; Retrospective Studies ; SARS-CoV-2 ; Secondary Care Centers ; Spain ; Time Factors ; Treatment Outcome</subject><ispartof>Revista española de quimioterapia, 2021-02, Vol.34 (1), p.33-43</ispartof><rights>The Author 2020. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).</rights><rights>The Author 2020 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-220f85a92e4f0b24de541ef9ba4ad8026360bebc7bc02c8281f91eabdb06f90f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876902/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876902/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33317261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vidal-Cortés, P</creatorcontrib><creatorcontrib>Del Río-Carbajo, L</creatorcontrib><creatorcontrib>Nieto-Del Olmo, J</creatorcontrib><creatorcontrib>Prol-Silva, E</creatorcontrib><creatorcontrib>Tizón-Varela, A I</creatorcontrib><creatorcontrib>Rodríguez-Vázquez, A</creatorcontrib><creatorcontrib>Rodríguez-Rodríguez, P</creatorcontrib><creatorcontrib>Díaz-López, M D</creatorcontrib><creatorcontrib>Fernández-Ugidos, P</creatorcontrib><creatorcontrib>Pérez-Veloso, M A</creatorcontrib><creatorcontrib>Intensive Care Unit. Ourense University Hospital, Spain</creatorcontrib><title>COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome</title><title>Revista española de quimioterapia</title><addtitle>Rev Esp Quimioter</addtitle><description>To assess the impact of corticosteroids on inflammatory and respiratory parameters of patients with COVID-19 and acute respiratory distress syndrome (ARDS).
Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Baseline characteristics, data on SARS-CoV-2 infection, treatment received, evolution of respiratory and inflammatory parameters, and ICU and hospital stay and mortality were analyzed.
A total of 27 patients were included, 63% men, median age: 68.4 (51.8, 72.2) years. All patients met ARDS criteria and received MV and corticosteroids. After corticosteroids treatment we observed a reduction in the O2 A-a gradient [day 0: 322 (249, 425); day 3: 169 (129.5, 239.5) p<0.001; day 5: 144 (127.5, 228.0) p<0.001; day 7: 192 (120, 261) p=0.002] and an increase in the pO2/FiO2 ratio on days 3 and 5, but not on day 7 [day 0: 129 (100, 168); day 3: 193 (140, 236) p=0.002; day 5: 183 (141, 255) p=0.004; day 7: 170 (116, 251) p=0.057]. CRP also decreased on days 3 and 5 and increased again on day 7 [day 0: 16 (8.6, 24); day 3: 3.4 (1.7, 10.2) p<0.001; day 5: 4.1 (1.4, 10.2) p<0.001; day 7: 13.5 (6.8, 17.3) p=0.063]. Persistence of moderate ARDS on day 7 was related to a greater risk of poor outcome (OR 6.417 [1.091-37.735], p=0.040).
Corticosteroids appears to reduce the inflammation and temporarily improve the oxygenation in COVID-19 and ARDS patients. Persistence of ARDS after 7 days treatment is a predictor of poor outcome.</description><subject>Aged</subject><subject>COVID-19 - metabolism</subject><subject>COVID-19 Drug Treatment</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Oxygen Consumption - drug effects</subject><subject>Oxygen Consumption - physiology</subject><subject>Respiration, Artificial</subject><subject>Respiratory Distress Syndrome - drug therapy</subject><subject>Respiratory Distress Syndrome - metabolism</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Secondary Care Centers</subject><subject>Spain</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0214-3429</issn><issn>1988-9518</issn><issn>1988-9518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc9rFDEUgIModls9epUcvcz2JZmdJBehbNUuFAq2eg2ZzItGdibTJCPsf9_0h8We3uF9fO_BR8gHBmshObDThLenoNmaA4dXZMW0Uo3eMPWarICzthEt10fkOOc_AK1oNXtLjoQQTPKOrUjeXv3cnTdMUzsN9MwtBel3zHNItsR0oOchl4Q50-vDNKQ44pruxtm6QqOnLqYSXMwFUwwDraAtI07lwTUnHIKrknyPzjEmGpfiquIdeePtPuP7p3lCfnz9crO9aC6vvu22Z5eNE0qWhnPwamM1x9ZDz9sBNy1Dr3vb2kEB70QHPfZO9g64U1wxrxnafuih8xq8OCGfH73z0o84uPpZsnszpzDadDDRBvNyM4Xf5lf8a6SSnQZeBZ-eBCneLpiLGUN2uN_bCeOSDW8lcCkV31S0eURdijkn9M9nGJiHUKaGMjWUuQ9V-Y____ZM_ysj7gCnSZHF</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Vidal-Cortés, P</creator><creator>Del Río-Carbajo, L</creator><creator>Nieto-Del Olmo, J</creator><creator>Prol-Silva, E</creator><creator>Tizón-Varela, A I</creator><creator>Rodríguez-Vázquez, A</creator><creator>Rodríguez-Rodríguez, P</creator><creator>Díaz-López, M D</creator><creator>Fernández-Ugidos, P</creator><creator>Pérez-Veloso, M A</creator><general>Sociedad Española de Quimioterapia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210201</creationdate><title>COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome</title><author>Vidal-Cortés, P ; Del Río-Carbajo, L ; Nieto-Del Olmo, J ; Prol-Silva, E ; Tizón-Varela, A I ; Rodríguez-Vázquez, A ; Rodríguez-Rodríguez, P ; Díaz-López, M D ; Fernández-Ugidos, P ; Pérez-Veloso, M A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-220f85a92e4f0b24de541ef9ba4ad8026360bebc7bc02c8281f91eabdb06f90f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>COVID-19 - metabolism</topic><topic>COVID-19 Drug Treatment</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Oxygen Consumption - drug effects</topic><topic>Oxygen Consumption - physiology</topic><topic>Respiration, Artificial</topic><topic>Respiratory Distress Syndrome - drug therapy</topic><topic>Respiratory Distress Syndrome - metabolism</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Secondary Care Centers</topic><topic>Spain</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Vidal-Cortés, P</creatorcontrib><creatorcontrib>Del Río-Carbajo, L</creatorcontrib><creatorcontrib>Nieto-Del Olmo, J</creatorcontrib><creatorcontrib>Prol-Silva, E</creatorcontrib><creatorcontrib>Tizón-Varela, A I</creatorcontrib><creatorcontrib>Rodríguez-Vázquez, A</creatorcontrib><creatorcontrib>Rodríguez-Rodríguez, P</creatorcontrib><creatorcontrib>Díaz-López, M D</creatorcontrib><creatorcontrib>Fernández-Ugidos, P</creatorcontrib><creatorcontrib>Pérez-Veloso, M A</creatorcontrib><creatorcontrib>Intensive Care Unit. Ourense University Hospital, Spain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Revista española de quimioterapia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vidal-Cortés, P</au><au>Del Río-Carbajo, L</au><au>Nieto-Del Olmo, J</au><au>Prol-Silva, E</au><au>Tizón-Varela, A I</au><au>Rodríguez-Vázquez, A</au><au>Rodríguez-Rodríguez, P</au><au>Díaz-López, M D</au><au>Fernández-Ugidos, P</au><au>Pérez-Veloso, M A</au><aucorp>Intensive Care Unit. Ourense University Hospital, Spain</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome</atitle><jtitle>Revista española de quimioterapia</jtitle><addtitle>Rev Esp Quimioter</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>34</volume><issue>1</issue><spage>33</spage><epage>43</epage><pages>33-43</pages><issn>0214-3429</issn><issn>1988-9518</issn><eissn>1988-9518</eissn><abstract>To assess the impact of corticosteroids on inflammatory and respiratory parameters of patients with COVID-19 and acute respiratory distress syndrome (ARDS).
Longitudinal, retrospective, observational study conducted in an ICU of a second level hospital. Adult patients with COVID-19 were included. Baseline characteristics, data on SARS-CoV-2 infection, treatment received, evolution of respiratory and inflammatory parameters, and ICU and hospital stay and mortality were analyzed.
A total of 27 patients were included, 63% men, median age: 68.4 (51.8, 72.2) years. All patients met ARDS criteria and received MV and corticosteroids. After corticosteroids treatment we observed a reduction in the O2 A-a gradient [day 0: 322 (249, 425); day 3: 169 (129.5, 239.5) p<0.001; day 5: 144 (127.5, 228.0) p<0.001; day 7: 192 (120, 261) p=0.002] and an increase in the pO2/FiO2 ratio on days 3 and 5, but not on day 7 [day 0: 129 (100, 168); day 3: 193 (140, 236) p=0.002; day 5: 183 (141, 255) p=0.004; day 7: 170 (116, 251) p=0.057]. CRP also decreased on days 3 and 5 and increased again on day 7 [day 0: 16 (8.6, 24); day 3: 3.4 (1.7, 10.2) p<0.001; day 5: 4.1 (1.4, 10.2) p<0.001; day 7: 13.5 (6.8, 17.3) p=0.063]. Persistence of moderate ARDS on day 7 was related to a greater risk of poor outcome (OR 6.417 [1.091-37.735], p=0.040).
Corticosteroids appears to reduce the inflammation and temporarily improve the oxygenation in COVID-19 and ARDS patients. Persistence of ARDS after 7 days treatment is a predictor of poor outcome.</abstract><cop>Spain</cop><pub>Sociedad Española de Quimioterapia</pub><pmid>33317261</pmid><doi>10.37201/req/091.2020</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Revista española de quimioterapia, 2021-02, Vol.34 (1), p.33-43 |
| issn | 0214-3429 1988-9518 1988-9518 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Aged COVID-19 - metabolism COVID-19 Drug Treatment Female Humans Intensive Care Units Longitudinal Studies Male Middle Aged Original Oxygen Consumption - drug effects Oxygen Consumption - physiology Respiration, Artificial Respiratory Distress Syndrome - drug therapy Respiratory Distress Syndrome - metabolism Retrospective Studies SARS-CoV-2 Secondary Care Centers Spain Time Factors Treatment Outcome |
| title | COVID-19 and Acute Respiratory Distress Syndrome. Impact of corticosteroid treatment and predictors of poor outcome |
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