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Steroid treatment may benefit some and harm others with COVID-19
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A blood test to assess C-reactive protein levels in patients with COVID-19 may help determine who will benefit from treatment with glucocorticoids and who will not. according to Hospital medical magazine..
This study UK recovery testThis indicates that in patients with COVID-19, treatment with dexamethasone reduced mortality by about one-third of those on ventilators and about one-fifth of those on oxygen. I will.
“While our research is in line with promising discoveries from the UK, we were able to demonstrate for the first time that people can see the same life-saving benefits of steroids other than dexamethasone.” Marla Keller, MD, In a press release, the vice chair of research at the Medical School at the Medical University of Albert Einstein and Montefiore Health Systems in New York said. “We also found that general blood tests could identify the best candidates for steroid treatment.”
Keller and colleagues evaluated 2,998 patients admitted to the Montefiore Medical Center in New York from March 11 to April 13. processing.
After exclusion, the study included 140 COVID-19 patients treated with glucocorticoids and 1,666 patients not receiving glucocorticoids.
Overall, the researchers found that glucocorticoid use within 48 hours of hospitalization was not associated with in-hospital mortality or mechanical ventilation.
When examining subgroups at the level of C-reactive protein (CRP), Keller and colleagues identified significant differences between the subgroups.
They found that early glucocorticoid use in patients with an initial CRP of 20 mg/dL or higher Death or mechanical ventilation In both unadjusted analysis (OR = 0.23; 95% CI, 0.08-0.7) and adjusted analysis (aOR = 0.2; 95% CI, 0.06-0.67).
However, for patients with CRP levels <10 mg / dL, unadjusted analysis (OR = 2.64; 95% CI, 1.39-5.03) and adjusted analysis (aOR = 3.14; 95% CI, 1.52-6.50).
“Our findings suggest that steroid therapy should be reserved for people with high inflammation, as evidenced by significantly elevated CRP levels.” William Southern, MD, MS, In a press release, he was a medical professor at Albert Einstein College of Medicine and Montefiore Health Systems and chief of hospital medicine. “This is another story for those who do not have significant inflammation. For them, the risk of using steroids is more important than any benefit.”
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