Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study
Abstract Corticosteroids use in coronavirus disease 2019 (COVID-19) is controversial, especially in mild to severe patients who do not require invasive/noninvasive ventilation. Moreover, many factors remain unclear regarding the appropriate use of corticosteroids for COVID-19. In this context, this...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/fa30d8dde05d4719aff209b6c00e31cc |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:fa30d8dde05d4719aff209b6c00e31cc |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:fa30d8dde05d4719aff209b6c00e31cc2021-12-02T14:59:06ZCorticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study10.1038/s41598-021-90246-y2045-2322https://doaj.org/article/fa30d8dde05d4719aff209b6c00e31cc2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90246-yhttps://doaj.org/toc/2045-2322Abstract Corticosteroids use in coronavirus disease 2019 (COVID-19) is controversial, especially in mild to severe patients who do not require invasive/noninvasive ventilation. Moreover, many factors remain unclear regarding the appropriate use of corticosteroids for COVID-19. In this context, this multicenter, retrospective, propensity score–matched study was launched to evaluate the efficacy of systemic corticosteroid administration for hospitalized patients with COVID-19 ranging in the degree of severity from mild to critically-ill disease. This multicenter, retrospective study enrolled consecutive hospitalized COVID-19 patients diagnosed January–April 2020 across 30 institutions in Japan. Clinical outcomes were compared for COVID-19 patients who received or did not receive corticosteroids, after adjusting for propensity scores. The primary endpoint was the odds ratio (OR) for improvement on a 7-point ordinal score on Day 15. Of 1092 COVID-19 patients analyzed, 118 patients were assigned to either the corticosteroid and non-corticosteroid group, after propensity score matching. At baseline, most patients did not require invasive/noninvasive ventilation (85.6% corticosteroid group vs. 89.8% non-corticosteroid group). The odds of improvement in a 7-point ordinal score on Day 15 was significantly lower for the corticosteroid versus non-corticosteroid group (OR, 0.611; 95% confidence interval [CI], 0.388–0.962; p = 0.034). The time to improvement in radiological findings was significantly shorter in the corticosteroid versus non-corticosteroid group (hazard ratio [HR], 1.758; 95% CI, 1.323–2.337; p < 0.001), regardless of baseline clinical status. The duration of invasive mechanical ventilation was shorter in corticosteroid versus non-corticosteroid group (HR, 1.466; 95% CI, 0.841–2.554; p = 0.177). Of the 106 patients who received methylprednisolone, the duration of invasive mechanical ventilation was significantly shorter in the pulse/semi-pulse versus standard dose group (HR, 2.831; 95% CI, 1.347–5.950; p = 0.006). In conclusion, corticosteroids for hospitalized patients with COVID-19 did not improve clinical status on Day 15, but reduced the time to improvement in radiological findings for all patients regardless of disease severity and also reduced the duration of invasive mechanical ventilation in patients who required intubation. Trial registration: This study was registered in the University hospital Medical Information Network Clinical Trials Registry on April 21, 2020 (ID: UMIN000040211).Satoshi IkedaToshihiro MisumiShinyu IzumiKeita SakamotoNaoki NishimuraShosei RoKoichi FukunagaSatoshi OkamoriNatsuo TachikawaNobuyuki MiyataMasaharu ShinkaiMasahiro ShinodaYasunari MiyazakiYuki IijimaTakehiro IzumoMinoru InomataMasaki OkamotoTomoyoshi YamaguchiKeisuke IwabuchiMakoto MasudaHiroyuki TakoiYoshitaka OyamadaShigeki FujitaniMasamichi MineshitaHaruyuki IshiiAtsushi NakagawaNobuhiro YamaguchiMakoto HibinoKenji TsushimaTatsuya NagaiSatoru IshikawaNobuhisa IshikawaYasuhiro KondohYoshitaka YamazakiKyoko GochoTomotaka NishizawaAkifumi TsuzukuKazuma YagiYuichiro ShindoYuriko TakedaTakeharu YamanakaTakashi OguraNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Satoshi Ikeda Toshihiro Misumi Shinyu Izumi Keita Sakamoto Naoki Nishimura Shosei Ro Koichi Fukunaga Satoshi Okamori Natsuo Tachikawa Nobuyuki Miyata Masaharu Shinkai Masahiro Shinoda Yasunari Miyazaki Yuki Iijima Takehiro Izumo Minoru Inomata Masaki Okamoto Tomoyoshi Yamaguchi Keisuke Iwabuchi Makoto Masuda Hiroyuki Takoi Yoshitaka Oyamada Shigeki Fujitani Masamichi Mineshita Haruyuki Ishii Atsushi Nakagawa Nobuhiro Yamaguchi Makoto Hibino Kenji Tsushima Tatsuya Nagai Satoru Ishikawa Nobuhisa Ishikawa Yasuhiro Kondoh Yoshitaka Yamazaki Kyoko Gocho Tomotaka Nishizawa Akifumi Tsuzuku Kazuma Yagi Yuichiro Shindo Yuriko Takeda Takeharu Yamanaka Takashi Ogura Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| description |
Abstract Corticosteroids use in coronavirus disease 2019 (COVID-19) is controversial, especially in mild to severe patients who do not require invasive/noninvasive ventilation. Moreover, many factors remain unclear regarding the appropriate use of corticosteroids for COVID-19. In this context, this multicenter, retrospective, propensity score–matched study was launched to evaluate the efficacy of systemic corticosteroid administration for hospitalized patients with COVID-19 ranging in the degree of severity from mild to critically-ill disease. This multicenter, retrospective study enrolled consecutive hospitalized COVID-19 patients diagnosed January–April 2020 across 30 institutions in Japan. Clinical outcomes were compared for COVID-19 patients who received or did not receive corticosteroids, after adjusting for propensity scores. The primary endpoint was the odds ratio (OR) for improvement on a 7-point ordinal score on Day 15. Of 1092 COVID-19 patients analyzed, 118 patients were assigned to either the corticosteroid and non-corticosteroid group, after propensity score matching. At baseline, most patients did not require invasive/noninvasive ventilation (85.6% corticosteroid group vs. 89.8% non-corticosteroid group). The odds of improvement in a 7-point ordinal score on Day 15 was significantly lower for the corticosteroid versus non-corticosteroid group (OR, 0.611; 95% confidence interval [CI], 0.388–0.962; p = 0.034). The time to improvement in radiological findings was significantly shorter in the corticosteroid versus non-corticosteroid group (hazard ratio [HR], 1.758; 95% CI, 1.323–2.337; p < 0.001), regardless of baseline clinical status. The duration of invasive mechanical ventilation was shorter in corticosteroid versus non-corticosteroid group (HR, 1.466; 95% CI, 0.841–2.554; p = 0.177). Of the 106 patients who received methylprednisolone, the duration of invasive mechanical ventilation was significantly shorter in the pulse/semi-pulse versus standard dose group (HR, 2.831; 95% CI, 1.347–5.950; p = 0.006). In conclusion, corticosteroids for hospitalized patients with COVID-19 did not improve clinical status on Day 15, but reduced the time to improvement in radiological findings for all patients regardless of disease severity and also reduced the duration of invasive mechanical ventilation in patients who required intubation. Trial registration: This study was registered in the University hospital Medical Information Network Clinical Trials Registry on April 21, 2020 (ID: UMIN000040211). |
| format |
article |
| author |
Satoshi Ikeda Toshihiro Misumi Shinyu Izumi Keita Sakamoto Naoki Nishimura Shosei Ro Koichi Fukunaga Satoshi Okamori Natsuo Tachikawa Nobuyuki Miyata Masaharu Shinkai Masahiro Shinoda Yasunari Miyazaki Yuki Iijima Takehiro Izumo Minoru Inomata Masaki Okamoto Tomoyoshi Yamaguchi Keisuke Iwabuchi Makoto Masuda Hiroyuki Takoi Yoshitaka Oyamada Shigeki Fujitani Masamichi Mineshita Haruyuki Ishii Atsushi Nakagawa Nobuhiro Yamaguchi Makoto Hibino Kenji Tsushima Tatsuya Nagai Satoru Ishikawa Nobuhisa Ishikawa Yasuhiro Kondoh Yoshitaka Yamazaki Kyoko Gocho Tomotaka Nishizawa Akifumi Tsuzuku Kazuma Yagi Yuichiro Shindo Yuriko Takeda Takeharu Yamanaka Takashi Ogura |
| author_facet |
Satoshi Ikeda Toshihiro Misumi Shinyu Izumi Keita Sakamoto Naoki Nishimura Shosei Ro Koichi Fukunaga Satoshi Okamori Natsuo Tachikawa Nobuyuki Miyata Masaharu Shinkai Masahiro Shinoda Yasunari Miyazaki Yuki Iijima Takehiro Izumo Minoru Inomata Masaki Okamoto Tomoyoshi Yamaguchi Keisuke Iwabuchi Makoto Masuda Hiroyuki Takoi Yoshitaka Oyamada Shigeki Fujitani Masamichi Mineshita Haruyuki Ishii Atsushi Nakagawa Nobuhiro Yamaguchi Makoto Hibino Kenji Tsushima Tatsuya Nagai Satoru Ishikawa Nobuhisa Ishikawa Yasuhiro Kondoh Yoshitaka Yamazaki Kyoko Gocho Tomotaka Nishizawa Akifumi Tsuzuku Kazuma Yagi Yuichiro Shindo Yuriko Takeda Takeharu Yamanaka Takashi Ogura |
| author_sort |
Satoshi Ikeda |
| title |
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| title_short |
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| title_full |
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| title_fullStr |
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| title_full_unstemmed |
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study |
| title_sort |
corticosteroids for hospitalized patients with mild to critically-ill covid-19: a multicenter, retrospective, propensity score-matched study |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/fa30d8dde05d4719aff209b6c00e31cc |
| work_keys_str_mv |
AT satoshiikeda corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT toshihiromisumi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT shinyuizumi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT keitasakamoto corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT naokinishimura corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT shoseiro corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT koichifukunaga corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT satoshiokamori corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT natsuotachikawa corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT nobuyukimiyata corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT masaharushinkai corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT masahiroshinoda corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yasunarimiyazaki corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yukiiijima corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT takehiroizumo corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT minoruinomata corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT masakiokamoto corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT tomoyoshiyamaguchi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT keisukeiwabuchi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT makotomasuda corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT hiroyukitakoi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yoshitakaoyamada corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT shigekifujitani corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT masamichimineshita corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT haruyukiishii corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT atsushinakagawa corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT nobuhiroyamaguchi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT makotohibino corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT kenjitsushima corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT tatsuyanagai corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT satoruishikawa corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT nobuhisaishikawa corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yasuhirokondoh corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yoshitakayamazaki corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT kyokogocho corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT tomotakanishizawa corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT akifumitsuzuku corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT kazumayagi corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yuichiroshindo corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT yurikotakeda corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT takeharuyamanaka corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy AT takashiogura corticosteroidsforhospitalizedpatientswithmildtocriticallyillcovid19amulticenterretrospectivepropensityscorematchedstudy |
| _version_ |
1718389240411193344 |