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Article

Benefits of Steroid Therapy in COVID-19 Patients with Different PaO2/FiO2 Ratio at Admission

National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Via Portuense, 292, 00149 Rome, Italy
*
Author to whom correspondence should be addressed.
Membership of the ReCOVeRI Study Group is provided in the acknowledgments.
Academic Editor: César Picado
J. Clin. Med. 2021, 10(15), 3236; https://doi.org/10.3390/jcm10153236
Received: 22 June 2021 / Revised: 14 July 2021 / Accepted: 19 July 2021 / Published: 22 July 2021
(This article belongs to the Special Issue Clinical Trends and Therapies of the COVID-19 Pandemic)
Introduction: The use of steroid therapy in patients within the context of SARS-CoV-2 infection is still a matter of debate. This study aimed to evaluate if potential steroid benefits could be predicted by the ratio of arterial oxygen partial pressure (PaO2 in mmHg) to fractional inspired oxygen (FiO2) (P/F) in COVID-19 patients at admission. Materials and Methods: Medical records were retrospectively collected from all adult patients admitted because of COVID-19 from 29 January to 31 July 2020. The association of steroid therapy with 28-day all-cause mortality outcome was analysed in a multivariable logistic regression model adjusted for confounding factors. Results: Overall, 511 patients were analysed, of which 39.1% underwent steroid therapy. Steroid treated patients were mostly male, older, and more frequently treated with antiviral drugs and aminoquinolines; the most common comorbidities were hypertension, followed by cardiovascular disease. Overall, 51 patients died within 28-days, and overall 28-days mortality was 19.5% in the cohort of patients exposed to steroids versus 3.9% mortality in unexposed patients (p < 0.001). Steroid therapy on patients with P/F ratio of 235 mmHg or higher at admission can be considered as detrimental, with an 8% increased probability of death. Conclusions: Steroid therapy is associated with increased 28-day mortality in COVID-19 in patients with mild or no ARDS. View Full-Text
Keywords: steroids; COVID-19; Sars-CoV-2 pneumonia; ARDS steroids; COVID-19; Sars-CoV-2 pneumonia; ARDS
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MDPI and ACS Style

Vita, S.; Centanni, D.; Lanini, S.; Piselli, P.; Rosati, S.; Giancola, M.L.; Mondi, A.; Pinnetti, C.; Topino, S.; Chinello, P.; Mosti, S.; Gualano, G.; Faraglia, F.; Iacomi, F.; Marchioni, L.; Maritti, M.; Girardi, E.; Ippolito, G.; Nicastri, E.; on behalf of the ReCOVeRI Study Group. Benefits of Steroid Therapy in COVID-19 Patients with Different PaO2/FiO2 Ratio at Admission. J. Clin. Med. 2021, 10, 3236. https://doi.org/10.3390/jcm10153236

AMA Style

Vita S, Centanni D, Lanini S, Piselli P, Rosati S, Giancola ML, Mondi A, Pinnetti C, Topino S, Chinello P, Mosti S, Gualano G, Faraglia F, Iacomi F, Marchioni L, Maritti M, Girardi E, Ippolito G, Nicastri E, on behalf of the ReCOVeRI Study Group. Benefits of Steroid Therapy in COVID-19 Patients with Different PaO2/FiO2 Ratio at Admission. Journal of Clinical Medicine. 2021; 10(15):3236. https://doi.org/10.3390/jcm10153236

Chicago/Turabian Style

Vita, Serena, Daniele Centanni, Simone Lanini, Pierluca Piselli, Silvia Rosati, Maria L. Giancola, Annalisa Mondi, Carmela Pinnetti, Simone Topino, Pierangelo Chinello, Silvia Mosti, Gina Gualano, Francesca Faraglia, Fabio Iacomi, Luisa Marchioni, Micaela Maritti, Enrico Girardi, Giuseppe Ippolito, Emanuele Nicastri, and on behalf of the ReCOVeRI Study Group. 2021. "Benefits of Steroid Therapy in COVID-19 Patients with Different PaO2/FiO2 Ratio at Admission" Journal of Clinical Medicine 10, no. 15: 3236. https://doi.org/10.3390/jcm10153236

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