@misc{10481/90889,
year = {2021},
month = {1},
url = {https://hdl.handle.net/10481/90889},
abstract = {Objective: Test whether high dose corticosteroid pulse therapy (HDCPT) with either methylprednisolone or dexamethasone is associated with increased survival in COVID-19 patients at risk of hyper-inflammatory response. Provide some initial diagnostic criteria using laboratory markers to stratify these patients.

Methods: This is a prospective observational study, 318 met the inclusion criteria. 64 patients (20.1%) were treated with HDCPT by using at least 1.5mg/kg/24h of methylprednisolone or dexamethasone equivalent. A multivariate Cox regression (controlling for co-morbidities and other therapies) was carried out to determine whether HDCPT (among other interventions) was associated with decreased mortality. We also carried out a 30-day time course analysis of laboratory markers between survivors and non-survivors, to identify potential markers for patient stratification.

Results: HDCPT showed a statistically significant decrease in mortality (HR = 0.087 [95% CI 0.021-0.36]; P < 0.001). 30-day time course analysis of laboratory marker tests showed marked differences in pro-inflammatory markers between survivors and non-survivors. As diagnostic criteria to define the patients at risk of developing a COVID-19 hyper-inflammatory response, we propose the following parameters (IL-6 > = 40 pg/ml, and/or two of the following: C-reactive protein > = 100 mg/L, D-dimer > = 1000 ng/ml, ferritin > = 500 ng/ml and lactate dehydrogenase > = 300 U/L).

Conclusions: HDCPT can be an effective intervention to increase COVID-19 survival rates in patients at risk of developing a COVID-19 hyper-inflammatory response, laboratory marker tests can be used to stratify these patients who should be given HDCPT. This study is not a randomized clinical trial (RCT). Future RCTs should be carried out to confirm the efficacy of HDCPT to increase the survival rates of COVID-19.},
title = {High-dose corticosteroid pulse therapy increases the survival rate in COVID-19 patients at risk of hyper-inflammatory response},
doi = {10.1371/journal.pone.0243964},
author = {López Zúñiga, Miguel Ángel and Moreno Moral, Aida and Ocaña Granados, Ana and Padilla Moreno, Francisco Andrés and Castillo Fernández, Ana María and Guillamón Fernández, Dionisio and Ramirez Sánchez, Carolina and Sanchez Palop, María and Martinez Colmenero, Justo and Pimentel Villar, María Amparo and Blazquez Roselló, Sara and Moreno Sanchez, Jose Juan and López Vilchez, María and Prior Sanchez, Inmaculada and Jodar Moreno, Rosario and López Ruz, Miguel Ángel},
}