About: Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia

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About: Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia
Creator	Lanini, Simone Confalonieri, Marco Radovanovic, Dejan Santus, Pierachille Oggionni, Tiberio Lacedonia, Donato Meduri, Umberto Umberger, Reba Phd, Alessandro Vianello, Andrea Bonifazi, Martina Caminati, Antonella Cao, Xueyuan Casarin, Annalisa Centanni, Stefano Confalonieri, Paola D'agaro, Pierlanfranco Davì, Matteo Fantin, Alberto Foschino Barbaro, Maria Gaccione, Anna Gasparini, Stefano Guidelli, Luca Harari, Sergio Licastro, Danilo Lucernoni, Paolo Mondoni, Michele Montico Msc, Marcella Parati, Mara Patruno, Vincenzo Poletti, Venerino Raccanelli, Rita Ravaglia, Claudia Romagnoli, Micaela Ruaro, Barbara Salton, Francesco Scala, Raffaele Scartabellati, Alessandro Tamburrini, Mario Tomassetti, Sara Torelli Dsc, Lucio Vertui, Valentina Villani, Massimiliano Volpe, Maria Zucchetto, Antonella
Source	MedRxiv
abstract	Background In hospitalized patients with COVID-19 pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for ICU and mortality. Methods We conducted a multicenter, observational study to explore the association between exposure to prolonged, low-dose, MP treatment and need for ICU referral, intubation or death within 28 days (composite primary endpoint) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units. Secondary outcomes were invasive MV-free days and changes in C-reactive protein (CRP) levels. Results Findings are reported as MP (n=83) vs. control (n=90). The composite primary endpoint was met by 19 vs. 40 [adjusted hazard ratio (HR) 0.41; 95% confidence interval (CI): 0.24-0.72]. Transfer to ICU and need for invasive MV was necessary in 15 vs. 27 (p=0.07) and 14 vs. 26 (p=0.10), respectively. By day 28, the MP group had fewer deaths (6 vs. 21, adjusted HR=0.29; 95% CI: 0.12-0.73) and more days off invasive MV (24.0 plus-or-minus sign 9.0 vs. 17.5 plus-or-minus sign 12.8; p=0.001). Study treatment was associated with rapid improvement in PaO2:FiO2 and CRP levels. The complication rate was similar for the two groups (p=0.84). Conclusion In patients with severe COVID-19 pneumonia, early administration of prolonged MP treatment was associated with a significantly lower hazard of death (71%) and decreased ventilator dependence. Randomized controlled studies are needed to confirm these findings.
has issue date	2020-06-20(xsd:dateTime)
bibo:doi	10.1101/2020.06.17.20134031
has license	medrxiv
sha1sum (hex)	40fedc43c7089d3257dc71907649fccbb9ef72de
schema:url	https://doi.org/10.1101/2020.06.17.20134031
resource representing a document's title	Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia
resource representing a document's body	covid:40fedc43c7089d3257dc71907649fccbb9ef72de#body_text
is schema:about of	named entity 'COVID-19' named entity 'pneumonia' named entity 'log-rank test' named entity 'ARDS' named entity 'pneumonia' named entity 'type 1 error' named entity 'HIV-positive' named entity 'SOFA score' named entity 'intensivists' named entity 'fewer deaths' named entity 'medRxiv' named entity 'comorbidities' named entity 'observational studies' named entity 'public health' named entity 'H1N1' named entity 'PaO2' named entity 'ventilator' named entity 'pneumonia' named entity 'confounding factors' named entity 'RT-PCR' named entity 'primary endpoint' named entity 'invasive mechanical ventilation' named entity 'SARS-CoV' named entity 'normal saline' named entity 'non-diabetic' named entity 'C-reactive protein' named entity 'noninvasive positive pressure ventilation' named entity 'pneumonia' named entity 'lung' named entity 'univariate' named entity 'mmHg' named entity 'COVID-19' named entity 'COVID-19' named entity 'heart failure' named entity 'critically ill' named entity 'primary endpoint' named entity 'composite endpoint' named entity 'standard of care' named entity 'ARF' named entity 'long-term' named entity 'intensive care units'

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