The Impact of Corticosteroids on Secondary Infection and Mortality in Critically Ill COVID-19 Patients.
J Intensive Care Med
; 36(10): 1201-1208, 2021 Oct.
Article
in English
| MEDLINE | ID: covidwho-1305547
ABSTRACT
BACKGROUND:
Corticosteroids are part of the treatment guidelines for COVID-19 and have been shown to improve mortality. However, the impact corticosteroids have on the development of secondary infection in COVID-19 is unknown. We sought to define the rate of secondary infection in critically ill patients with COVID-19 and determine the effect of corticosteroid use on mortality in critically ill patients with COVID-19. STUDY DESIGN ANDMETHODS:
One hundred and thirty-five critically ill patients with COVID-19 admitted to the Intensive Care Unit (ICU) at the University of Maryland Medical Center were included in this single-center retrospective analysis. Demographics, symptoms, culture data, use of COVID-19 directed therapies, and outcomes were abstracted from the medical record. The primary outcomes were secondary infection and mortality. Proportional hazards models were used to determine the time to secondary infection and the time to death.RESULTS:
The proportion of patients with secondary infection was 63%. The likelihood of developing secondary infection was not significantly impacted by the administration of corticosteroids (HR 1.45, CI 0.75-2.82, P = 0.28). This remained consistent in sub-analysis looking at bloodstream, respiratory, and urine infections. Secondary infection had no significant impact on the likelihood of 28-day mortality (HR 0.66, CI 0.33-1.35, P = 0.256). Corticosteroid administration significantly reduced the likelihood of 28-day mortality (HR 0.27, CI 0.10-0.72, P = 0.01).CONCLUSION:
Corticosteroids are an important and lifesaving pharmacotherapeutic option in critically ill patients with COVID-19, which have no impact on the likelihood of developing secondary infections.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Coinfection
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
Limits:
Humans
Language:
English
Journal:
J Intensive Care Med
Journal subject:
Critical Care
Year:
2021
Document Type:
Article
Affiliation country:
08850666211032175
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