预先存在的间歇性肺部疾病患者的COVID-19:基于类固醇的治疗策略的潜在价值
Toru Arai1, Yu Kurahara1,2, Mitsuhiro Moda3
1Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City 591-8555, Osaka Prefecture, Japan.
Journal of clinical medicine
|August 12, 2023
概括
皮质类固醇治疗改善了COVID-19患者和先前存在的间歇性肺部疾病 (preILD) 的结果. 这一策略显示,这一脆弱群体的30天死亡率为0%,预后比以前报告的更好.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 患有COVID-19和先前存在的间歇性肺病 (preILD) 的患者面临着不良预后.
- 对于这种患者群体,没有确立的治疗策略.
研究的目的:
- 评估基于类固醇的治疗策略对COVID-19患者的有效性.
- 评估皮质类固醇和雷梅西维尔对患者结果的影响.
主要方法:
- 在2020年3月至2021年10月期间接受治疗的610名COVID-19患者的回顾性评估.
- 鉴定和分析7名患有preILD的患者,这些患者接受了皮质类固醇和remdesivir.
- 评估呼吸支需求,排放状态和死亡率.
主要成果:
- 包括7名男性患者,平均年龄为63岁.
- 在四个严重的COVID-19病例中,有三例需要呼吸系统支持,所有病例都成功断奶.
- 一个严重的病例与一个做-not-resuscitate命令去世;另一个死在医院. 所有中度病例均已出院.
- 30天死亡率为0%,整体死亡率为28.5%.
结论:
- 基于类固醇的管理策略可能改善了COVID-19患者的预后.
- 这个队列的结果比以前的报告要好,表明治疗有效性.
- 需要进一步的研究来证实皮质类固醇在这个特定的患者群体中的益处.
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