Dexamethasone use and mortality in hospitalized patients with coronavirus disease 2019 : A multicentre retrospective observational study

© 2021 British Pharmacological Society..

AIMS: To examine the association between dexamethasone use and mortality among patients hospitalized for COVID-19.

METHODS: We examined the association between dexamethasone use and mortality at AP-HP Greater Paris University hospitals. Study baseline was defined as the date of hospital admission. The primary endpoint was time to death. We compared this endpoint between patients who received dexamethasone and those who did not in time-to-event analyses adjusted for patient characteristics (such as age, sex and comorbidity) and clinical and biological markers of clinical severity of COVID-19, and stratified by the need for respiratory support, i.e. mechanical ventilation or oxygen. The primary analysis was a multivariable Cox regression model.

RESULTS: Of 12 217 adult patients hospitalized with a positive COVID-19 reverse transcriptase-polymerase chain reaction test, 171 (1.4%) received dexamethasone orally or by intravenous perfusion during the visit. Among patients who required respiratory support, the end-point occurred in 10/63 (15.9%) patients who received dexamethasone and 298/1129 (26.4%) patients who did not. In this group, there was a significant association between dexamethasone use and reduced mortality in the primary analysis (hazard ratio, 0.46; 95% confidence interval 0.22-0.96, P = .039). Among patients who did not require respiratory support, there was no significant association between dexamethasone use and the endpoint.

CONCLUSIONS: In this multicentre observational study, dexamethasone use administered either orally or by intravenous injection at a cumulative dose between 60 mg and 150 mg was associated with reduced mortality among patients with COVID-19 requiring respiratory support.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

British journal of clinical pharmacology - Vol. 87, No. 10 (2021), p. 3766-3775

Language:

English

Contributors:

Hoertel, Nicolas
Sánchez-Rico, Marina
Vernet, Raphaël
Beeker, Nathanaël
Neuraz, Antoine
Alvarado, Jesús M
Daniel, Christel
Paris, Nicolas
Gramfort, Alexandre
Lemaitre, Guillaume
Salamanca, Elisa
Bernaux, Mélodie
Bellamine, Ali
Burgun, Anita
Limosin, Frédéric
AP-HP/Université de Paris/INSERM Covid-19 research collaboration and AP-HP Covid CDR Initiative

Links:

Volltext

Keywords:

*COVID-19
*Coronavirus Infections
7S5I7G3JQL
Adult
COVID-19
Dexamethasone
Efficacy
Hospitalization
Humans
Journal Article
Mortality
Multicenter Study
Observational Study
Oxygen
Retrospective Studies
SARS-CoV-2
Treatment
Ventilation

Notes:

Date Completed 01.10.2021

Date Revised 01.10.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/bcp.14784

PMID:

33608891

PPN (Catalogue-ID):

NLM32274038X