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Revista de la OFIL

versão On-line ISSN 1699-714Xversão impressa ISSN 1131-9429

Resumo

GARCIA MUNOZ, S et al. High-dose versus low-dose corticosteroid treatment strategy in patients hospitalised with COVID-19: effect on ICU admission rate. Rev. OFIL·ILAPHAR [online]. 2021, vol.31, n.1, pp.13-17.  Epub 07-Jun-2021. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2021000100003.

Objective:

COVID-19 is associated with lung damage and a high mortality rate in hospitalised patients. Corticoids may reduce the evolution to respiratory failure and death. This study aims to assess the effect on the ICU admission rate of a change in corticosteroid treatment strategy, administering low versus high doses.

Methods:

A retrospective, observational study was designed. Confirmed COVID-19 patients indicated to start treatment with corticosteroids were enrolled. To study the association between the type of corticosteroid used and admission to the ICU, a binary logistic regression model was constructed. This model included variables that could cause confusion or influence the response: gender, age, comorbidities, and analytical data.

Results:

From 190 admitted patients, 127 were enrolled in the study. In both groups, patients received a minimum of two doses of corticosteroids during admission. 12.4% (12/97) of the patients who received methylprednisolone (high doses) were subsequently admitted to the ICU, compared to 30.0% (9/30) of the patients who received dexamethasone (low doses). In the logistic regression model constructed, the type of corticosteroid (low-dose dexamethasone) (p=0.002), male gender (p=0.023), age over 50 years (p=0.014) and IL-6 level >70 pg/mL (p=0.004) remained as predictive factors for admission to the ICU.

Conclusions:

In the studied population of patients hospitalised for COVID-19, the use of high-dose methylprednisolone is associated with a lower rate of admission to the ICU than the administration of low-dose dexamethasone.

Palavras-chave : SARS-Cov-2; COVID-19; corticosteroids; ICU.

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