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High-dose corticosteroid pulse therapy increases the survival rate in COVID-19 patients at risk of hyper-inflammatory response
dc.contributor.author | López Zúñiga, Miguel Ángel | |
dc.contributor.author | Moreno Moral, Aida | |
dc.contributor.author | Ocaña Granados, Ana | |
dc.contributor.author | Padilla Moreno, Francisco Andrés | |
dc.contributor.author | Castillo Fernández, Ana María | |
dc.contributor.author | Guillamón Fernández, Dionisio | |
dc.contributor.author | Ramirez Sánchez, Carolina | |
dc.contributor.author | Sanchez Palop, María | |
dc.contributor.author | Martinez Colmenero, Justo | |
dc.contributor.author | Pimentel Villar, María Amparo | |
dc.contributor.author | Blazquez Roselló, Sara | |
dc.contributor.author | Moreno Sanchez, Jose Juan | |
dc.contributor.author | López Vilchez, María | |
dc.contributor.author | Prior Sanchez, Inmaculada | |
dc.contributor.author | Jodar Moreno, Rosario | |
dc.contributor.author | López Ruz, Miguel Ángel | |
dc.date.accessioned | 2024-04-19T06:33:39Z | |
dc.date.available | 2024-04-19T06:33:39Z | |
dc.date.issued | 2021-01 | |
dc.identifier.citation | PLoS One . 2021 Jan 28;16(1):e0243964 | es_ES |
dc.identifier.uri | https://hdl.handle.net/10481/90889 | |
dc.description.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. | es_ES |
dc.language.iso | eng | es_ES |
dc.rights | Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/ | es_ES |
dc.title | High-dose corticosteroid pulse therapy increases the survival rate in COVID-19 patients at risk of hyper-inflammatory response | es_ES |
dc.type | journal article | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.identifier.doi | 10.1371/journal.pone.0243964 |