Department of Pulmonary and Critical Care Medicine, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Shock. 2020 Nov;54(5):638-643. doi: 10.1097/SHK.0000000000001574.
The effects of corticosteroid treatment on non-severe COVID-19 pneumonia patients are unknown. To determine the impacts of adjuvant corticosteroid administrated to patients with non-severe COVID-19 pneumonia.
A retrospective cohort study based on propensity score analysis was designed to explore the effects of corticosteroid on several clinical outcomes.
One hundred thirty-two patients satisfied the inclusion criteria and 35 pairs were generated according to propensity score matching. Compared to non-corticosteroid group, the CT score on day 7 was significantly higher in corticosteroid group (8.6 (interquartile range [IQR], 2.8-11.5) versus 12.0 (IQR, 5.0-19.3), P = 0.046). In corticosteroid group, more patients progressed to severe cases (11.4% versus 2.9%, P = 0.353), hospital stay (23.5 days (IQR, 19-29 d) versus 20.2 days (IQR, 14-25.3 d), P = 0.079) and duration of viral shedding (20.3 days (IQR, 15.2-24.8 d) versus 19.4 days (IQR, 11.5-28.3 d), P = 0.669) were prolonged, while fever time (9.5 days (IQR, 6.5-12.2 d) versus 10.2 days (IQR, 6.8-14 d), P = 0.28) was shortened; however, all these data revealed no statistically significant differences.
Corticosteroid might have a negative effect on lung injury recovery in non-severe COVID-19 pneumonia patients; however, the results of this study must be interpreted with caution because of confounding factors.
皮质类固醇治疗对非重症 COVID-19 肺炎患者的影响尚不清楚。本研究旨在确定辅助皮质类固醇治疗非重症 COVID-19 肺炎患者的影响。
采用倾向评分分析的回顾性队列研究，探讨皮质类固醇对多种临床结局的影响。
符合纳入标准的患者共 132 例，根据倾向评分匹配，共匹配 35 对。与非皮质类固醇组相比，皮质类固醇组第 7 天 CT 评分明显更高（8.6（四分位距 [IQR]，2.8-11.5）与 12.0（IQR，5.0-19.3），P=0.046）。皮质类固醇组进展为重症病例的患者更多（11.4%与 2.9%，P=0.353），住院时间（23.5 天（IQR，19-29 d）与 20.2 天（IQR，14-25.3 d），P=0.079）和病毒脱落时间（20.3 天（IQR，15.2-24.8 d）与 19.4 天（IQR，11.5-28.3 d），P=0.669）延长，而发热时间（9.5 天（IQR，6.5-12.2 d）与 10.2 天（IQR，6.8-14 d），P=0.28）缩短，但所有数据均无统计学差异。
皮质类固醇可能对非重症 COVID-19 肺炎患者的肺损伤恢复产生负面影响；然而，由于混杂因素的影响，本研究结果必须谨慎解释。
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