Unidad de Enfermedades Sistémicas, Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España.
Departamento de Bioestadística, Facultad de Medicina, Universidad de Granada, Granada, España.
Med Clin (Barc). 2020 Aug 28;155(4):159-161. doi: 10.1016/j.medcli.2020.04.018. Epub 2020 May 27.
Cytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids. Our objective is to evaluate the efficacy of GC in the CSS by COVID-19.
We included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. We determine CSS markers. We evaluated mortality, intubation, and a combined variable.
In all cases the percentages of events were lower in the group of patients with GC was administered. The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival.
The early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death.
细胞因子风暴综合征(CSS)是 COVID-19 患者的严重并发症。治疗方法是托珠单抗。糖皮质激素(GC)的使用存在争议。在其他非常相似的 CSS 中,如巨噬细胞活化综合征(MAS)和噬血细胞综合征(HFS),主要治疗方法是皮质类固醇。我们的目的是评估 COVID-19 相关 CSS 中 GC 的疗效。
我们纳入了 92 例接受 GC、GC 和托珠单抗以及仅托珠单抗治疗的 COVID-19 相关 CSS 患者。我们确定了 CSS 标志物。我们评估了死亡率、插管和综合变量。
在所有情况下,接受 GC 治疗的患者组中事件的百分比较低。考虑到 CGs,与仅接受托珠单抗治疗的组相比,GC 治疗的最终变量的危险比更低,具有统计学意义的是生存率。
早期使用 GC 脉冲可以控制 SLC,减少对托珠单抗的需求,并降低插管和死亡等事件的发生。