Patterns of corticosteroid use among remdesivir and matched patients and associated clinical outcomes in hospitalized COVID-19 patients
INTRODUCTION: We aimed to investigate patterns of corticosteroid use and their relationship with remdesivir use and clinical outcomes in a large real-life cohort of COVID-19 patients treated in a tertiary-level institution.
METHODS: We retrospectively analyzed a total of 1558 severe and critical COVID-19 patients, including 779 patients treated with remdesivir and 779 matched control patients.
RESULTS: A total of 167 (10.7%) patients received none, 710 (45.6%) low, 539 (34.6%) high, and 142 (9.1%) very high corticosteroid doses. Patients treated with remdesivir had significantly longer exposure to corticosteroids, received higher average and maximal daily doses, and cumulative corticosteroid doses. In the multivariate analysis remdesivir use, lower cumulative comorbidity burden, higher severity of COVID-19 symptoms, and mechanical ventilation were recognized as mutually independent predictors of the use of higher corticosteroid doses. Higher corticosteroid doses were associated with significantly increased mortality.Among non-remdesivir treated patients, there was a U-shaped relationship between maximal daily corticosteroid dose and mortality. Among remdesivir treated patients gradual increase in mortality with increasing corticosteroid doses was observed.
CONCLUSION: Patterns of corticosteroid use differ regarding the use of remdesivir and may moderate its association with survival among severe and critical COVID-19 patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
|---|---|
| Enthalten in: |
Expert opinion on pharmacotherapy - 25(2024), 2 vom: 16. Feb., Seite 215-222 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Papic, Ivan [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
3QKI37EEHE |
|---|
| Anmerkungen: |
Date Completed 27.03.2024 Date Revised 27.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1080/14656566.2024.2320255 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368528499 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368528499 | ||
| 003 | DE-627 | ||
| 005 | 20240327235823.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240216s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/14656566.2024.2320255 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1351.xml |
| 035 | |a (DE-627)NLM368528499 | ||
| 035 | |a (NLM)38362773 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Papic, Ivan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Patterns of corticosteroid use among remdesivir and matched patients and associated clinical outcomes in hospitalized COVID-19 patients |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.03.2024 | ||
| 500 | |a Date Revised 27.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: We aimed to investigate patterns of corticosteroid use and their relationship with remdesivir use and clinical outcomes in a large real-life cohort of COVID-19 patients treated in a tertiary-level institution | ||
| 520 | |a METHODS: We retrospectively analyzed a total of 1558 severe and critical COVID-19 patients, including 779 patients treated with remdesivir and 779 matched control patients | ||
| 520 | |a RESULTS: A total of 167 (10.7%) patients received none, 710 (45.6%) low, 539 (34.6%) high, and 142 (9.1%) very high corticosteroid doses. Patients treated with remdesivir had significantly longer exposure to corticosteroids, received higher average and maximal daily doses, and cumulative corticosteroid doses. In the multivariate analysis remdesivir use, lower cumulative comorbidity burden, higher severity of COVID-19 symptoms, and mechanical ventilation were recognized as mutually independent predictors of the use of higher corticosteroid doses. Higher corticosteroid doses were associated with significantly increased mortality.Among non-remdesivir treated patients, there was a U-shaped relationship between maximal daily corticosteroid dose and mortality. Among remdesivir treated patients gradual increase in mortality with increasing corticosteroid doses was observed | ||
| 520 | |a CONCLUSION: Patterns of corticosteroid use differ regarding the use of remdesivir and may moderate its association with survival among severe and critical COVID-19 patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Remdesivir | |
| 650 | 4 | |a corticosteroids | |
| 650 | 4 | |a dexamethasone, methylprednisolone | |
| 650 | 4 | |a prednisone | |
| 650 | 4 | |a prognosis | |
| 650 | 7 | |a remdesivir |2 NLM | |
| 650 | 7 | |a 3QKI37EEHE |2 NLM | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Antiviral Agents |2 NLM | |
| 650 | 7 | |a Adenosine Monophosphate |2 NLM | |
| 650 | 7 | |a 415SHH325A |2 NLM | |
| 650 | 7 | |a Alanine |2 NLM | |
| 650 | 7 | |a OF5P57N2ZX |2 NLM | |
| 700 | 1 | |a Bistrovic, Petra |e verfasserin |4 aut | |
| 700 | 1 | |a Keres, Tatjana |e verfasserin |4 aut | |
| 700 | 1 | |a Ortner Hadziabdic, Maja |e verfasserin |4 aut | |
| 700 | 1 | |a Lucijanic, Marko |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Expert opinion on pharmacotherapy |d 1999 |g 25(2024), 2 vom: 16. Feb., Seite 215-222 |w (DE-627)NLM111602130 |x 1744-7666 |7 nnns |
| 773 | 1 | 8 | |g volume:25 |g year:2024 |g number:2 |g day:16 |g month:02 |g pages:215-222 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/14656566.2024.2320255 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 25 |j 2024 |e 2 |b 16 |c 02 |h 215-222 | ||