Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study
- Creators
- Pagnesi M.
- Inciardi R. M.
- Lombardi C. M.
- Agostoni P.
- Ameri P.
- Barbieri L.
- Bellasi A.
- Camporotondo R.
- Canale C.
- Carubelli V.
- Carugo S.
- Catagnano F.
- Dalla Vecchia L. A.
- Danzi G. B.
- Di Pasquale M.
- Gaudenzi M.
- Giovinazzo S.
- Gnecchi M.
- Guazzi M.
- Iorio A.
- La Rovere M. T.
- Leonardi S.
- Maccagni G.
- Mapelli M.
- Margonato D.
- Merlo M.
- Monzo L.
- Mortara A.
- Nuzzi V.
- Piepoli M.
- Porto I.
- Pozzi A.
- Sarullo F.
- Sinagra G.
- Tedino C.
- Tomasoni D.
- Volterrani M.
- Zaccone G.
- Senni M.
- Metra M.
- Others:
- Pagnesi, M.
- Inciardi, R. M.
- Lombardi, C. M.
- Agostoni, P.
- Ameri, P.
- Barbieri, L.
- Bellasi, A.
- Camporotondo, R.
- Canale, C.
- Carubelli, V.
- Carugo, S.
- Catagnano, F.
- Dalla Vecchia, L. A.
- Danzi, G. B.
- Di Pasquale, M.
- Gaudenzi, M.
- Giovinazzo, S.
- Gnecchi, M.
- Guazzi, M.
- Iorio, A.
- La Rovere, M. T.
- Leonardi, S.
- Maccagni, G.
- Mapelli, M.
- Margonato, D.
- Merlo, M.
- Monzo, L.
- Mortara, A.
- Nuzzi, V.
- Piepoli, M.
- Porto, I.
- Pozzi, A.
- Sarullo, F.
- Sinagra, G.
- Tedino, C.
- Tomasoni, D.
- Volterrani, M.
- Zaccone, G.
- Senni, M.
- Metra, M.
Description
Background: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality. Methods: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality. Results: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26–0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L). Conclusions: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.
Additional details
- URL
- http://hdl.handle.net/11567/1066413
- URN
- urn:oai:iris.unige.it:11567/1066413
- Origin repository
- UNIGE