Outcomes of Adjunctive Corticosteroid Treatment on Hypoxemic Adults Hospitalised for Mycoplasma pneumoniae Pneumonia: a Retrospective Cohort Study
Corticosteroids appears to be beneficial for severe Mycoplasma pneumoniae pneumonia in children but data in adults are limited. This study investigated effects of adjunctive corticosteroids in hypoxemic adults with M. pneumoniae pneumonia. Adults admitted 2013-2017 with verified M. pneumoniae pneumo...
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| creator | Hagman, Karl Nilsson, Anna C Hedenstierna, Magnus Ursing, Johan |
| description | Corticosteroids appears to be beneficial for severe Mycoplasma pneumoniae pneumonia in children but data in adults are limited. This study investigated effects of adjunctive corticosteroids in hypoxemic adults with M. pneumoniae pneumonia.
Adults admitted 2013-2017 with verified M. pneumoniae pneumonia and hypoxemia (SpO2 |
| doi_str_mv | 10.1093/cid/ciae451 |
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Adults admitted 2013-2017 with verified M. pneumoniae pneumonia and hypoxemia (SpO2<93% or oxygen treatment) were included in a cohort. Treatment was defined as receipt of at least one glucocorticoid dose.Primary outcome was time to regression of hypoxemia, analysed with a multivariable Cox regression. Secondary outcomes included fever duration, length of stay, and complications.
Corticosteroids were given to 31% (122/388) during hypoxemia. Median age was 44 (IQR 34-57) years. Median time to start of corticosteroid treatment was 1.9 (IQR 0.6-3.6) days from admission. Median cumulative dose was equivalent to 15 (IQR 10-19) mg betamethasone. Treatment duration was 5 (IQR 3-6) days. Patients treated with corticosteroids had more severe respiratory disease, longer symptom duration and were more often treated with fluoroquinolones.Time to regression of hypoxemia (HR 0.92 [95% CI 0.72-1.19], P = 0.53) and length of stay (HR 0.91 [95% CI 0.71-1.16], P = 0.44) were not significantly different between corticosteroid treated and controls. Corticosteroid treatment was associated to shorter fever duration (HR 1.44 [95% CI 1.00-2.06], P = 0.046). Complications did not differ significantly between treatment groups.
Adjunctive corticosteroids were not associated with reduced time to regression of hypoxemia in adults with M. pneumoniae pneumonia. However, duration of fever was shorter and no increase in complications was seen.</description><identifier>ISSN: 1058-4838</identifier><identifier>ISSN: 1537-6591</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciae451</identifier><identifier>PMID: 39230949</identifier><language>eng</language><publisher>United States</publisher><subject>adults ; corticosteroids ; Immunologi inom det medicinska området ; Immunology in the medical area ; Medicin och hälsovetenskap ; Mycoplasma pneumoniae ; pneumonia ; treatment</subject><ispartof>Clinical infectious diseases, 2024-09</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c303t-3d30d8389f8358b58d24bc3bebd796a8231c9eb7e137e13f1045e337a0345b973</cites><orcidid>0000-0001-8539-9820 ; 0000-0002-5965-6130</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39230949$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/342035$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:159658583$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Hagman, Karl</creatorcontrib><creatorcontrib>Nilsson, Anna C</creatorcontrib><creatorcontrib>Hedenstierna, Magnus</creatorcontrib><creatorcontrib>Ursing, Johan</creatorcontrib><title>Outcomes of Adjunctive Corticosteroid Treatment on Hypoxemic Adults Hospitalised for Mycoplasma pneumoniae Pneumonia: a Retrospective Cohort Study</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Corticosteroids appears to be beneficial for severe Mycoplasma pneumoniae pneumonia in children but data in adults are limited. This study investigated effects of adjunctive corticosteroids in hypoxemic adults with M. pneumoniae pneumonia.
Adults admitted 2013-2017 with verified M. pneumoniae pneumonia and hypoxemia (SpO2<93% or oxygen treatment) were included in a cohort. Treatment was defined as receipt of at least one glucocorticoid dose.Primary outcome was time to regression of hypoxemia, analysed with a multivariable Cox regression. Secondary outcomes included fever duration, length of stay, and complications.
Corticosteroids were given to 31% (122/388) during hypoxemia. Median age was 44 (IQR 34-57) years. Median time to start of corticosteroid treatment was 1.9 (IQR 0.6-3.6) days from admission. Median cumulative dose was equivalent to 15 (IQR 10-19) mg betamethasone. Treatment duration was 5 (IQR 3-6) days. Patients treated with corticosteroids had more severe respiratory disease, longer symptom duration and were more often treated with fluoroquinolones.Time to regression of hypoxemia (HR 0.92 [95% CI 0.72-1.19], P = 0.53) and length of stay (HR 0.91 [95% CI 0.71-1.16], P = 0.44) were not significantly different between corticosteroid treated and controls. Corticosteroid treatment was associated to shorter fever duration (HR 1.44 [95% CI 1.00-2.06], P = 0.046). Complications did not differ significantly between treatment groups.
Adjunctive corticosteroids were not associated with reduced time to regression of hypoxemia in adults with M. pneumoniae pneumonia. However, duration of fever was shorter and no increase in complications was seen.</description><subject>adults</subject><subject>corticosteroids</subject><subject>Immunologi inom det medicinska området</subject><subject>Immunology in the medical area</subject><subject>Medicin och hälsovetenskap</subject><subject>Mycoplasma pneumoniae</subject><subject>pneumonia</subject><subject>treatment</subject><issn>1058-4838</issn><issn>1537-6591</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kk9v1DAQxSNERf_AiTvyEQkF7Eyc2NyqFe0iFRVBOVuOPSkuSRxiG7pfg0-MV7tbTuUw8mj0e29s6xXFS0bfMirhnXE2l8aasyfFCePQlg2X7GnuKRdlLUAcF6ch3FHKmKD8WXEMsgIqa3lS_LlO0fgRA_E9Obd3aTLR_UKy8kt0xoeIi3eW3Cyo44hTJH4i683s73F0JgvSEANZ-zC7qAcX0JLeL-TTxvh50GHUZJ4wjX7K9yOfD-17oskXjEuW4WHd97yQfI3Jbp4XR70eAr7Yn2fFt4sPN6t1eXV9-XF1flUaoBBLsEBtfpvsBXDRcWGrujPQYWdb2WhRATMSuxYZbKtntOYI0GoKNe9kC2dFufMNv3FOnZoXN-plo7x2aj_6kTtUQlRNJTIvH-Xnxdt_ooOQcdlwwQX8d9dtmlUe3aatBOqKAs_86x2fjX8mDFGNLhgcBj2hT0EBo5Q3NTCZ0Tc71OT_DAv2D-aMqm1AVA6I2gck06_2xqkb0T6wh0TAXxB_vM8</recordid><startdate>20240904</startdate><enddate>20240904</enddate><creator>Hagman, Karl</creator><creator>Nilsson, Anna C</creator><creator>Hedenstierna, Magnus</creator><creator>Ursing, Johan</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><orcidid>https://orcid.org/0000-0001-8539-9820</orcidid><orcidid>https://orcid.org/0000-0002-5965-6130</orcidid></search><sort><creationdate>20240904</creationdate><title>Outcomes of Adjunctive Corticosteroid Treatment on Hypoxemic Adults Hospitalised for Mycoplasma pneumoniae Pneumonia: a Retrospective Cohort Study</title><author>Hagman, Karl ; Nilsson, Anna C ; Hedenstierna, Magnus ; Ursing, Johan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-3d30d8389f8358b58d24bc3bebd796a8231c9eb7e137e13f1045e337a0345b973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>adults</topic><topic>corticosteroids</topic><topic>Immunologi inom det medicinska området</topic><topic>Immunology in the medical area</topic><topic>Medicin och hälsovetenskap</topic><topic>Mycoplasma pneumoniae</topic><topic>pneumonia</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hagman, Karl</creatorcontrib><creatorcontrib>Nilsson, Anna C</creatorcontrib><creatorcontrib>Hedenstierna, Magnus</creatorcontrib><creatorcontrib>Ursing, Johan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hagman, Karl</au><au>Nilsson, Anna C</au><au>Hedenstierna, Magnus</au><au>Ursing, Johan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Adjunctive Corticosteroid Treatment on Hypoxemic Adults Hospitalised for Mycoplasma pneumoniae Pneumonia: a Retrospective Cohort Study</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2024-09-04</date><risdate>2024</risdate><issn>1058-4838</issn><issn>1537-6591</issn><eissn>1537-6591</eissn><abstract>Corticosteroids appears to be beneficial for severe Mycoplasma pneumoniae pneumonia in children but data in adults are limited. This study investigated effects of adjunctive corticosteroids in hypoxemic adults with M. pneumoniae pneumonia.
Adults admitted 2013-2017 with verified M. pneumoniae pneumonia and hypoxemia (SpO2<93% or oxygen treatment) were included in a cohort. Treatment was defined as receipt of at least one glucocorticoid dose.Primary outcome was time to regression of hypoxemia, analysed with a multivariable Cox regression. Secondary outcomes included fever duration, length of stay, and complications.
Corticosteroids were given to 31% (122/388) during hypoxemia. Median age was 44 (IQR 34-57) years. Median time to start of corticosteroid treatment was 1.9 (IQR 0.6-3.6) days from admission. Median cumulative dose was equivalent to 15 (IQR 10-19) mg betamethasone. Treatment duration was 5 (IQR 3-6) days. Patients treated with corticosteroids had more severe respiratory disease, longer symptom duration and were more often treated with fluoroquinolones.Time to regression of hypoxemia (HR 0.92 [95% CI 0.72-1.19], P = 0.53) and length of stay (HR 0.91 [95% CI 0.71-1.16], P = 0.44) were not significantly different between corticosteroid treated and controls. Corticosteroid treatment was associated to shorter fever duration (HR 1.44 [95% CI 1.00-2.06], P = 0.046). Complications did not differ significantly between treatment groups.
Adjunctive corticosteroids were not associated with reduced time to regression of hypoxemia in adults with M. pneumoniae pneumonia. However, duration of fever was shorter and no increase in complications was seen.</abstract><cop>United States</cop><pmid>39230949</pmid><doi>10.1093/cid/ciae451</doi><orcidid>https://orcid.org/0000-0001-8539-9820</orcidid><orcidid>https://orcid.org/0000-0002-5965-6130</orcidid></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current) |
| subjects | adults corticosteroids Immunologi inom det medicinska området Immunology in the medical area Medicin och hälsovetenskap Mycoplasma pneumoniae pneumonia treatment |
| title | Outcomes of Adjunctive Corticosteroid Treatment on Hypoxemic Adults Hospitalised for Mycoplasma pneumoniae Pneumonia: a Retrospective Cohort Study |
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