Department of Emergency/Critical Care Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China.
Department of Critical Care Medicine, Huangshi Hospital of TCM (Infectious Disease Hospital), 12 Guangchang Road, Huangshi, China.
J Int Med Res. 2023 Feb;51(2):3000605221149292. doi: 10.1177/03000605221149292.
We aimed to investigate the clinical effects of intravenous glucocorticoid (GC) therapy for severe COVID-19 pneumonia.
Seventy-two patients hospitalized with severe COVID-19 pneumonia who were discharged or died between 5 January 2020 and 3 March 2020 at Huangshi Infectious Disease Hospital were included. Patients were divided into a treatment group (GC group) and non-treatment group (non-GC group) according to whether they had received GCs within 7 days of hospital admission.
There was no significant difference between groups for Acute Physiology and Chronic Health Evaluation (APACHE) II score and 28-day survival rate. The rate of invasive mechanical ventilation was higher in the GC group than in the non-GC group. On day 7 after admission, the GC group had shorter fever duration and higher white blood cell count than the non-GC group. In subgroup analysis by age and severity, there was no significant difference in 28-day survival rate and other indicators. Compared with those in the non-GC group, patients in the GC group more frequently required admission to the intensive care unit.
In the present study, we found no significant improvement in patients with severe COVID-19 pneumonia treated with GCs within 7 days of admission.
本研究旨在探讨静脉用糖皮质激素(GC)治疗重症 COVID-19 肺炎的临床疗效。
纳入 2020 年 1 月 5 日至 2020 年 3 月 3 日期间在黄石市传染病医院住院且出院或死亡的 72 例重症 COVID-19 肺炎患者。根据患者入院后 7 天内是否使用过 GCs 将其分为治疗组(GC 组)和非治疗组(非 GC 组)。
两组间急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分和 28 天生存率差异无统计学意义。GC 组有创机械通气率高于非 GC 组。入院第 7 天,GC 组发热持续时间短于非 GC 组,白细胞计数高于非 GC 组。在按年龄和严重程度进行的亚组分析中,两组间 28 天生存率和其他指标差异均无统计学意义。与非 GC 组相比,GC 组患者更常需要入住重症监护病房。
本研究发现,入院后 7 天内使用 GCs 治疗重症 COVID-19 肺炎患者的临床疗效无显著改善。