Dataset Information

Corticosteroids Treatment of Patients with Coronavirus Disease 2019: A Propensity Score Matching Study.

ABSTRACT: The role of corticosteroids in the treatment of Coronavirus disease 2019 (COVID-19) is controversial. In the present study, we evaluated the effects of adjuvant corticosteroids treatment on the outcome of patients with COVID-19 (n=966), using Propensity Score Matching to adjust for potential differences between the corticosteroids group (n=289) and the non-corticosteroids group (n=677). Analysis of data without adjusting differences in baseline characteristics indicated that the proportion of mechanical ventilation and the mortality was higher in the corticosteroids treatment group in total or severe/critical patients. The duration of viral shedding was longer in the non-corticosteroids treatment group in total or general/mild patients. After adjusting the difference between the corticosteroids and non-corticosteroids treatment group, the analysis revealed that the use of corticosteroids had no effect on the duration of viral shedding, in-hospital mortality or 28-day mortality.

SUBMITTER: Liang MY

PROVIDER: S-EPMC7881915 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Corticosteroids Treatment of Patients with Coronavirus Disease 2019: A Propensity Score Matching Study.

Liang Meng-Yuan MY Chen Ping P He Miao M Tang Jian J Li Hui H He Xin-Liang XL Zhou Ya-Ya YY Feng Si-Wei SW Xue Yu-E YE Liu Yao Y Ma Yan-Ling YL Zhang Jian-Chu JC

Current medical science 20210213 1

The role of corticosteroids in the treatment of Coronavirus disease 2019 (COVID-19) is controversial. In the present study, we evaluated the effects of adjuvant corticosteroids treatment on the outcome of patients with COVID-19 (n=966), using Propensity Score Matching to adjust for potential differences between the corticosteroids group (n=289) and the non-corticosteroids group (n=677). Analysis of data without adjusting differences in baseline characteristics indicated that the proportion of me ...[more]

PMID: 33582901

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Project description:To determine the impact of tocilizumab, a monoclonal antibody against the interleukin 6 receptor, on survival in patients with coronavirus disease 2019.DesignObservational cohort study of patients hospitalized with coronavirus disease 2019 between March 1, 2020, and April 24, 2020. A propensity-matched (1:1) analysis was used to compare patients who received tocilizumab to controls who did not. Competing risk survival analysis was used to determine the primary outcome of time to mortality, and adjusted log-linear and logistic regression for secondary outcomes.SettingThree hospitals within the NYU Langone Health system in New York.PatientsConsecutive adult patients hospitalized with coronavirus disease 2019.InterventionTocilizumab 400-mg IV once in addition to standard of care or standard of care alone.Measurements and main resultsData from 3,580 severe acute respiratory syndrome coronavirus 2 positive qualifying hospitalized patients were included, of whom 497 (13.9%) were treated with tocilizumab. In the analysis of tocilizumab-treated patients and matched controls, fewer tocilizumab-treated patients died (145/497, 29.2%) than did controls (211/497, 42.4%). In the adjusted competing risk regression model, tocilizumab therapy was associated with improved survival relative to controls (hazard ratio = 0.24, 95% CI = 0.18-0.33, p < 0.001). Tocilizumab-treated patients and controls had similar adjusted time to discharge from hospital (hazard ratio = 0.96, 95% CI = 0.78-1.17, p = 0.67). However, they had longer adjusted ICU length of stay (rate ratio = 3.1, 95% CI = 2.5-3.7, p < 0.001) and a higher adjusted infection rate (odds ratio = 4.18, 95% CI = 2.72-6.52, p < 0.001) than controls.ConclusionsTocilizumab therapy was associated with significantly improved survival in coronavirus disease 2019 patients. This survival benefit was associated with increased ICU length of stay and increased infection rate, even as more patients in the tocilizumab group were rescued from rapid death. A prospective, randomized, placebo-controlled trial is needed to confirm these findings.

Dataset Information

Corticosteroids Treatment of Patients with Coronavirus Disease 2019: A Propensity Score Matching Study.

Publications

Corticosteroids Treatment of Patients with Coronavirus Disease 2019: A Propensity Score Matching Study.

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