About: Abstract : Introduction: Steroids have theoretically seems useful in critically ill patients of COVID-19 . However the time of starting steroid and dose remains a matter of concern due to still emerging evidences and wide-ranging concerns of benefits and harms. We did a retrospective record analysis in an apex teaching hospital ICU setting to explore this concern. Methodology: 45 adults age more than 18 years with nasopharyngeal swab PCR-confirmed SARS-CoV-2 infection with ARDS admitted to ICU in between 20th March,2020 to 15th July 2020 were included in chart review. We did a bivariate analysis of age ,comorbidity, infections, severity of disease , timing /dose(appropriate) steroid and presence of infection on survival. In the next step we performed a Bayesian Exact regression to understand the adjusted effect of early appropriate steroid on survival in the presence of age and infections as probable confounder. Results: Bivariate analysis showed the statistically significant effect of age <60 years and steroid dose (early and classified by disease severity) had a favourable effect on outcome. Further Early Pulse Steroid (EPS ) amongst the more severe subgroup was found to be significantly associated with better survival. Conclusion: High dose steroids (more than 500 mg MPS) if given early in the course of disease to COVID19 critically ill patients (P/F<150) can significantly reduce mortality and are not associated with increased infections.   Goto Sponge  NotDistinct  Permalink

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  • Abstract : Introduction: Steroids have theoretically seems useful in critically ill patients of COVID-19 . However the time of starting steroid and dose remains a matter of concern due to still emerging evidences and wide-ranging concerns of benefits and harms. We did a retrospective record analysis in an apex teaching hospital ICU setting to explore this concern. Methodology: 45 adults age more than 18 years with nasopharyngeal swab PCR-confirmed SARS-CoV-2 infection with ARDS admitted to ICU in between 20th March,2020 to 15th July 2020 were included in chart review. We did a bivariate analysis of age ,comorbidity, infections, severity of disease , timing /dose(appropriate) steroid and presence of infection on survival. In the next step we performed a Bayesian Exact regression to understand the adjusted effect of early appropriate steroid on survival in the presence of age and infections as probable confounder. Results: Bivariate analysis showed the statistically significant effect of age <60 years and steroid dose (early and classified by disease severity) had a favourable effect on outcome. Further Early Pulse Steroid (EPS ) amongst the more severe subgroup was found to be significantly associated with better survival. Conclusion: High dose steroids (more than 500 mg MPS) if given early in the course of disease to COVID19 critically ill patients (P/F<150) can significantly reduce mortality and are not associated with increased infections.
Subject
  • Zoonoses
  • Viral respiratory tract infections
  • Intensive care medicine
  • COVID-19
  • Medical education
  • Occupational safety and health
  • Teaching hospitals
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