Abstract | OBJECTIVES: METHODS: We included patients with COVID-19 pneumonia admitted to 11 ICUs belonging to the French OutcomeReaTM network from January to May 2020. We used survival models with ponderation with inverse probability of treatment weighting (IPTW). RESULTS: The study population comprised 303 patients having a median age of 61.6 (53-70) years of whom 78.8% were male and 58.6% had at least one comorbidity. The median SAPS II was 33 (25-44). Invasive mechanical ventilation was required in 34.8% of the patients. Sixty-six (21.8%) patients were in the Early-C subgroup. Overall, 60-day mortality was 29.4%. The risks of 60-day mortality (IPTWHR = 0.86;95% CI 0.54 to 1.35, p = 0.51), ICU-BSI and HAP-VAP were similar in the two groups. Importantly, early CS treatment was associated with a lower mortality rate in patients aged 60 years or more (IPTWHR, 0.53;95% CI, 0.3-0.93; p = 0.03). In contrast, CS was associated with an increased risk of death in patients younger than 60 years without inflammation on admission (IPTWHR = 5.01;95% CI, 1.05, 23.88; p = 0.04). CONCLUSION: For patients with COVID-19 pneumonia, early CS treatment was not associated with patient survival. Interestingly, inflammation and age can significantly influence the effect of CS.
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Authors | Claire Dupuis, Etienne de Montmollin, Niccolò Buetti, Dany Goldgran-Toledano, Jean Reignier, Carole Schwebel, Julien Domitile, Mathilde Neuville, Moreno Ursino, Shidasp Siami, Stéphane Ruckly, Corinne Alberti, Bruno Mourvillier, Sebastien Bailly, Virginie Laurent, Marc Gainnier, Bertrand Souweine, Jean-François Timsit, OutcomeReaTM research network |
Journal | PloS one
(PLoS One)
Vol. 16
Issue 8
Pg. e0255644
( 2021)
ISSN: 1932-6203 [Electronic] United States |
PMID | 34347836
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adrenal Cortex Hormones
(administration & dosage)
- Adult
- Aged
- COVID-19
(mortality, therapy)
- Cohort Studies
- Community Networks
- Critical Illness
(mortality, therapy)
- Drug Administration Schedule
- Early Medical Intervention
(methods)
- Female
- France
(epidemiology)
- Hospital Mortality
- Humans
- Intensive Care Units
(statistics & numerical data)
- Male
- Middle Aged
- Respiration, Artificial
(mortality, statistics & numerical data)
- Time Factors
- Treatment Outcome
- COVID-19 Drug Treatment
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