2019年冠状病毒病患者的类固醇启动时间和结果:一个多中心,回顾性,观察性研究
Ryu Sugimoto1, Tsuneaki Kenzaka1,2, Ayako Mikami3
1Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan.
International journal of immunopathology and pharmacology
|November 17, 2023
概括
在重症COVID-19患者中,早期的德克萨米他 (DEXA) 与较高的死亡率有关. 延迟的类固醇启动显示出更好的生存结果,这表明谨慎的时间是管理严重的冠状病毒疾病2019的关键.
科学领域:
- * 关键护理医学 关键护理医学
- * 传染病 传染病
- * 药理学 药理学 药理学
背景情况:
- * 德克萨 (DEXA) 在危急的冠状病毒疾病2019 (COVID-19) 患者中显示有生存益处.
- *以前的研究和元分析支持DEXA的疗效.
- * 类固醇启动的最佳时间仍然是一个关键问题.
研究的目的:
- * 调查Covid-19患者中德甲启动时间和死亡率之间的关联.
- * 确定影响类固醇时间和结果之间的关系的因素.
- * 为了澄清早期与延迟类固醇管理的影响.
主要方法:
- *使用日本COVID-19注册表 (2020年1月 - 2021年4月) 进行的多中心,回顾性,观察性研究.
- *纳入标准:COVID-19阳性患者 (PCR,LAMP或抗原测试),年龄>=18岁.
- *排除标准:特定的先前存在的疾病,怀孕,类固醇使用,转移,发病原因不明.
主要成果:
- *分析包括3692名患者;64.1%是男性,平均年龄68岁.
- *早期启动DEXA与较高的死亡率 (13.3%与7.9%,p <.001) 和严重疾病的风险因素有关.
- *多变量分析表明,在症状出现后>=8天开始使用类固醇的死亡率下降的趋势 (aOR 0.7,p = .05).
结论:
- *在COVID-19患者中早期服用德克萨米他可能与死亡率的增加有关.
- *研究结果表明,可能存在早期严重疾病或早期类固醇使用带来的不良反应的患者子组.
- *在COVID-19管理中启动德克萨梅他的最佳时间需要进一步调查.
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