与COVID-19系统性皮质类固醇相关的1年健康结果:纵向队列研究
Olivia C Leavy1,2,3, Richard J Russell2,3, Ewen M Harrison4
1Department of Population Health Sciences, University of Leicester, Leicester, UK.
ERJ open research
|October 1, 2024
概括
对于严重的COVID-19而言,甲治疗在医院出院一年后没有改善长期与健康相关的生活质量 (HRQoL). 需要进一步的研究,以找到有效的治疗方法,持续的HRQoL问题在COVID-19幸存者.
科学领域:
- 医学研究 医学研究
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 德克萨米他减少了急性严重性,并改善了需要氧气的COVID-19患者的生存率.
- 德克萨米他对COVID-19后与健康相关的生活质量 (HRQoL) 的长期影响尚不清楚.
- 假设:在急性COVID-19期间使用皮质类固醇可以在出院一年后改善HRQoL.
研究的目的:
- 调查急性COVID-19和HRQoL在医院出院后一年期间系统性皮质类固醇施用之间的关联.
- 将接受皮质类固醇和未接受皮质类固醇的COVID-19患者之间的HRQoL结果进行比较.
- 评估二次结果,包括患者报告的康复和器官功能障碍.
主要方法:
- 使用了两项前性英国队列研究 (住院后COVID-19和国际严重急性呼吸道和新兴感染联盟).
- 包括在2020年2月至2021年3月期间因COVID-19住院的成人,他们有资格接受德克萨.
- HRQoL (EQ-5D-5L UI) 在医院前和出院后的一年被评估,并对治疗比较进行倾向权重. 敏感性分析考虑了生存率和选择偏差.
主要成果:
- 在接受皮质类固醇和不接受皮质类固醇的患者之间,在一年内没有观察到EQ-5D-5L UI的显著差异 (平均差异为0.004).
- 这两组在一年后,EQ-5D-5L UI的减少也相似.
- 在一个更大的队列 (109,318名患者) 中,二次结局和敏感性分析也没有显示一年HRQoL的差异.
结论:
- 在急性COVID-19期间服用全身皮质类固醇不会影响医院出院后一年观察到的HRQoL显著减少.
- 迫切需要治疗方法来解决COVID-19幸存者的HRQoL持续下降的问题.
- 研究结果表明,虽然德克萨米他对急性COVID-19有益,但它并不能减轻长期生活质量缺陷.
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