OUTCOMES OF COVID-19 PATIENTS: ARE HISPANICS AT GREATER RISK?

Unadjusted mortality was higher in Whites than Hispanics (17.1% versus 10.7%;p< 0.001), however, after adjusting for confounding variables, in-hospital mortality was no different for Whites in comparison to Hispanics (HR 0.96, 95% CI 0.76-1.21, p=0.73). We compared in hospital mortality, use of intensive care unit services (rates of mechanical ventilation, vasopressor use and renal replacement therapy) between non-Hispanic whites with non-White/Black Hispanic. B Conclusions: b Hispanics as compared to Whites with COVID-19 require higher rates of ICU admission but have a similar mortality. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

IS UNCONTROLLED DIABETES PRIOR TO HOSPITALIZATION A RISK FACTOR FOR WORSE OUTCOMES IN COVID-19?

B Conclusions: b Poorly controlled diabetes as judged by higher HbA1c had less severe COVID infection on admission, however, it was not associated with higher severity of COVID19 during the admission. The probability of in-hospital mortality and rate of readmissions decreased with increasing levels of HbA1c. B Introduction: b Diabetes is a known risk factor for COVID19 infection. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

TOCILIZUMAB IN COVID-19 PATIENTS REQUIRING INVASIVE MECHANICAL VENTILATION: WHO BENEFITS MOST?

B Methods: b We identified primary admissions of all adult COVID19 patients on invasive mechanical ventilation (IMV) in EMR with positive COVID19 test results. B Introduction: b In severe Covid 19 infection, cytokine storm possibly plays a role in development of worsening of symptoms and possibly worse outcomes. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Do high-dose corticosteroids improve outcomes in hospitalized COVID-19 patients?

Coronavirus disease 2019 (COVID-19) is characterized by dysregulated hyperimmune response and steroids have been shown to decrease mortality. However, whether higher dosing of steroids results in better outcomes has been debated. This was a retrospective observation of COVID-19 admissions between March 1, 2020, and March 10, 2021. Adult patients (≥18 years) who received more than 10 mg daily methylprednisolone equivalent dosing (MED) within the first 14 days were included. We excluded patients who were discharged or died within 7 days of admission. We compared the standard dose of steroids (<40 mg MED) versus the high dose of steroids (>40 mg MED). Inverse probability weighted regression adjustment (IPWRA) was used to examine whether higher dose steroids resulted in improved outcomes. The outcomes studied were in-hospital mortality, rate of acute kidney injury (AKI) requiring hemodialysis, invasive mechanical ventilation (IMV), hospital-associated infections (HAI), and readmissions. Of the 1379 patients meeting study criteria, 506 received less than 40 mg of MED (median dose 30 mg MED) and 873 received more than or equal to 40 mg of MED (median dose 78 mg MED). Unadjusted in-hospital mortality was higher in patients who received high-dose corticosteroids (40.7% vs. 18.6%, p < 0.001). On IPWRA, the use of high-dose corticosteroids was associated with higher odds of death (odds ratio [OR] 2.14; 95% confidence interval [CI] 1.45-3.14, p < 0.001) but not with the development of HAI, readmissions, or requirement of IMV. High-dose corticosteroids were associated with lower rates of AKI requiring hemodialysis (OR 0.33; 95% CI 0.18-0.63). In COVID-19, corticosteroids more than or equal to 40 mg MED were associated with higher in-hospital mortality.