Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study
Objectives: To assess the outcomes of corticosteroid treatment in critically ill patients with respiratory virus–related community-acquired pneumonia (CAP). Materials/methods: Adult patients who were admitted to the intensive care unit and had a polymerase chain reaction–confirmed diagnosis of respi...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118223000671 |
| _version_ | 1797749153074249728 |
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| author | Ching-Hao Hsu Andrew Po-Liang Chen Hsin-Pai Chen Yu-Jiun Chan |
| author_facet | Ching-Hao Hsu Andrew Po-Liang Chen Hsin-Pai Chen Yu-Jiun Chan |
| author_sort | Ching-Hao Hsu |
| collection | DOAJ |
| description | Objectives: To assess the outcomes of corticosteroid treatment in critically ill patients with respiratory virus–related community-acquired pneumonia (CAP). Materials/methods: Adult patients who were admitted to the intensive care unit and had a polymerase chain reaction–confirmed diagnosis of respiratory virus–related CAP were included. Patients with and without corticosteroid treatment during the hospital course were retrospectively compared using a propensity score–matched case–control analysis. Results: From January 2018 to December 2020, 194 adult patients were enrolled with 1:1 matching. The 14-day and 28-day mortality rates did not differ significantly between patients treated with and without corticosteroids (14-day mortality: 7% versus 14%, P = 0.11; 28-day mortality: 15% versus 20%, P = 0.35). However, multivariate analysis by using a Cox regression model revealed that corticosteroid treatment was an independent factor predicting decreased mortality (adjusted odds ratio, 0.46; 95% confidence interval, 0.22–0.97, P = 0.04). Subgroup analysis revealed lower 14-day and 28-day mortality rates in patients younger than 70 years treated with corticosteroids than in those not treated with corticosteroids (14-day mortality: 6% versus 23%; P = 0.01 and 28-day mortality: 12% versus 27%; P = 0.04). Conclusions: Non-elderly patients with severe respiratory virus–related CAP are more likely to benefit from corticosteroid treatment than elderly patients. |
| first_indexed | 2024-03-12T16:15:09Z |
| format | Article |
| id | doaj.art-1807732c0aa24355a77c7627a58310c9 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-03-12T16:15:09Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-1807732c0aa24355a77c7627a58310c92023-08-09T04:32:16ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822023-08-01564757765Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control studyChing-Hao Hsu0Andrew Po-Liang Chen1Hsin-Pai Chen2Yu-Jiun Chan3Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Corresponding author. Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11247, Taiwan. Fax: +886 2 2873 5656.Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Infection Control, Taipei Veterans General Hospital, Taipei, TaiwanObjectives: To assess the outcomes of corticosteroid treatment in critically ill patients with respiratory virus–related community-acquired pneumonia (CAP). Materials/methods: Adult patients who were admitted to the intensive care unit and had a polymerase chain reaction–confirmed diagnosis of respiratory virus–related CAP were included. Patients with and without corticosteroid treatment during the hospital course were retrospectively compared using a propensity score–matched case–control analysis. Results: From January 2018 to December 2020, 194 adult patients were enrolled with 1:1 matching. The 14-day and 28-day mortality rates did not differ significantly between patients treated with and without corticosteroids (14-day mortality: 7% versus 14%, P = 0.11; 28-day mortality: 15% versus 20%, P = 0.35). However, multivariate analysis by using a Cox regression model revealed that corticosteroid treatment was an independent factor predicting decreased mortality (adjusted odds ratio, 0.46; 95% confidence interval, 0.22–0.97, P = 0.04). Subgroup analysis revealed lower 14-day and 28-day mortality rates in patients younger than 70 years treated with corticosteroids than in those not treated with corticosteroids (14-day mortality: 6% versus 23%; P = 0.01 and 28-day mortality: 12% versus 27%; P = 0.04). Conclusions: Non-elderly patients with severe respiratory virus–related CAP are more likely to benefit from corticosteroid treatment than elderly patients.http://www.sciencedirect.com/science/article/pii/S1684118223000671Viral pneumoniaCorticosteroidsIntensive careAge factors |
| spellingShingle | Ching-Hao Hsu Andrew Po-Liang Chen Hsin-Pai Chen Yu-Jiun Chan Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study Journal of Microbiology, Immunology and Infection Viral pneumonia Corticosteroids Intensive care Age factors |
| title | Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study |
| title_full | Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study |
| title_fullStr | Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study |
| title_full_unstemmed | Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study |
| title_short | Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia – a propensity-matched case control study |
| title_sort | outcomes of corticosteroid treatment in critical ill adult patients with respiratory viruses related community acquired pneumonia a propensity matched case control study |
| topic | Viral pneumonia Corticosteroids Intensive care Age factors |
| url | http://www.sciencedirect.com/science/article/pii/S1684118223000671 |
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