Montalvan-Sanchez Eleazar, Chambergo-Michilot Diego, Rodriguez-Murillo Aida A, Brooks Alexandra E, Palacios-Argenal Dairy, Rivera-Pineda Shery, Ordonez-Montes Jose, Estevez-Ramirez Rosa, Riva-Moscoso Adrian, Norwood Dalton A, Calderon-Rodriguez Alex, Pineda-SanMartin Elizabeth, Giron Roberto, Rivera-Corrales Luis, Carcamo-Murillo Balduino, Garner Orlando
Indiana University School of Medicine Department of Medicine Indianapolis, IN USA.
Universidad Cientifica del Sur Departamento de Medicina Lima Peru.
J Acute Med. 2023 Mar 1;13(1):36-40. doi: 10.6705/j.jacme.202303_13(1).0005.
To compare the clinical outcomes of a low dose dexamethasone strategy vs. a high-dose dexamethasone strategy in hypoxemic COVID-19 patients. A retrospective observational study comparing low-dose (8 mg) and high-dose dexamethasone (24 mg) of COVID-19 patients admitted from September 1, 2020 to October 31, 2020 in a hospital in Honduras. We included 81 patients with confirmed COVID-19 who required oxygen therapy. The mean age was similar between groups (57.49 vs. 56.95 years). There were more male patients in the group of 24 mg ( = 0.01). Besides, patients on the 24 mg dose had more prevalence of hypertension ( = 0.052). More patients in the 24 mg group had a higher rate of invasive mechanical ventilation (15.00% vs. 2.56%, = 0.058). When evaluating the association between the high dose group and outcomes, we find no significant association with mortality, nosocomial infections, high flow mask, invasive mechanical ventilation, or the need for vasopressors. We find no significant differences in the Kaplan-Meier analysis regarding the survival (log-rank -value = 0.315). We did not find significant differences between the use of 24 mg and 8 mg of dexamethasone in hypoxemic COVID-19 patients.
比较低剂量地塞米松策略与高剂量地塞米松策略在低氧血症型新冠病毒病（COVID-19）患者中的临床结局。一项回顾性观察性研究，比较了2020年9月1日至2020年10月31日在洪都拉斯一家医院收治的COVID-19患者使用低剂量（8毫克）和高剂量地塞米松（24毫克）的情况。我们纳入了81例确诊COVID-19且需要氧疗的患者。两组患者的平均年龄相似（57.49岁对56.95岁）。24毫克组男性患者更多（P = 0.01）。此外，24毫克剂量组患者高血压患病率更高（P = 0.052）。24毫克组更多患者有创机械通气率更高（15.00%对2.56%，P = 0.058）。在评估高剂量组与结局之间的关联时，我们发现其与死亡率、医院感染、高流量面罩、有创机械通气或血管活性药物使用需求均无显著关联。在生存情况的Kaplan-Meier分析中我们未发现显著差异（对数秩P值 = 0.315）。我们未发现低氧血症型COVID-19患者使用24毫克和8毫克地塞米松之间存在显著差异。
