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Predictive factors of response to systemic corticosteroids in patients hospitalized with COVID-19 pneumoniae

Iria Veiga Teijeiro, Indhira Guzmán Peralta, Diego Pérez Ortiz, Luis Pérez De Llano, Irene Martín Robles, Nagore Blanco Cid, David Dacal Rivas, Rafael Golpe Gómez
European Respiratory Journal 2021 58: PA3652; DOI: 10.1183/13993003.congress-2021.PA3652
Iria Veiga Teijeiro
1Lucus Augusti University Hospital, Lugo, Spain
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  • For correspondence: iriaveigat@hotmail.com
Indhira Guzmán Peralta
1Lucus Augusti University Hospital, Lugo, Spain
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Diego Pérez Ortiz
1Lucus Augusti University Hospital, Lugo, Spain
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Luis Pérez De Llano
1Lucus Augusti University Hospital, Lugo, Spain
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Irene Martín Robles
1Lucus Augusti University Hospital, Lugo, Spain
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Nagore Blanco Cid
1Lucus Augusti University Hospital, Lugo, Spain
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David Dacal Rivas
1Lucus Augusti University Hospital, Lugo, Spain
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Rafael Golpe Gómez
1Lucus Augusti University Hospital, Lugo, Spain
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Abstract

Background: COVID19 pneumonia is probably the most frequent cause of death in this infection. We aimed to identify factors related to favorable response to systemic corticosteroids.

Methods: multicenter retrospective post-hoc study of patients with COVID19 pneumonia who received systemic corticosteroids. Multivariate analysis considering independent variables: age, gender, comorbidities (Charlson index), inflammatory status (by CRP), presence of respiratory failure (SpO2 < 90%), days from symptom onset to corticosteroid prescription, maximum corticosteroid dose, use of corticosteroid bolus and concomitant tocilizumab. Dependent variable was a composite of death and orotracheal intubation (OTI). Optimal cut-off point was obtained from ROC analysis.

Results: 479 patients. Composite outcome was reached in 190(39.6%)cases. Those who reached it were older, with higher comorbidity load, lower SpO2 and higher CRP. They had shorter interval between symptom onset and corticosteroids use. They also received more frequently bolus and tocilizumab. Regarding the multivariable logistic regression analysis: older age, use of bolus and use of tocilizumab were significantly associated with a higher risk to reach the composite outcome, while higher SpO2 and a longer interval from symptoms onset to corticosteroid prescription were associated to a lower risk of reaching the adverse outcome. Best cut-off values to rule-out the composite outcome were:≤ 73 years(95%CI:63–81.2), SaO2:>89%(95%CI:87–89), >9days for time from symptoms onset to corticosteroid treatment(95%CI:5.1–12).

Conclusion: greater mortality benefit in response to corticosteroids if longer duration of symtoms, as Recovery Trial.

  • Covid-19
  • Pneumonia
  • Treatments

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3652.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Predictive factors of response to systemic corticosteroids in patients hospitalized with COVID-19 pneumoniae
Iria Veiga Teijeiro, Indhira Guzmán Peralta, Diego Pérez Ortiz, Luis Pérez De Llano, Irene Martín Robles, Nagore Blanco Cid, David Dacal Rivas, Rafael Golpe Gómez
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3652; DOI: 10.1183/13993003.congress-2021.PA3652

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Predictive factors of response to systemic corticosteroids in patients hospitalized with COVID-19 pneumoniae
Iria Veiga Teijeiro, Indhira Guzmán Peralta, Diego Pérez Ortiz, Luis Pérez De Llano, Irene Martín Robles, Nagore Blanco Cid, David Dacal Rivas, Rafael Golpe Gómez
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3652; DOI: 10.1183/13993003.congress-2021.PA3652
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