Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study
Abstract Background The impact of corticosteroids on patients with severe coronavirus disease 2019 (COVID-19)/chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate the association of corticosteroids on these patients. Methods This retrospective multicenter study...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-022-07882-6 |
| _version_ | 1797985515526422528 |
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| author | Mei Meng Yufeng Chu Sheng Zhang Xuechuan Li Jing Sha Peng Wang Yunliang Cui Meihong Han Xuan Dong Wenqing Sun Zhongfa Zhang Yunxin Deng Tao Wang Djillali Annane Shouqiang Jia Dechang Chen |
| author_facet | Mei Meng Yufeng Chu Sheng Zhang Xuechuan Li Jing Sha Peng Wang Yunliang Cui Meihong Han Xuan Dong Wenqing Sun Zhongfa Zhang Yunxin Deng Tao Wang Djillali Annane Shouqiang Jia Dechang Chen |
| author_sort | Mei Meng |
| collection | DOAJ |
| description | Abstract Background The impact of corticosteroids on patients with severe coronavirus disease 2019 (COVID-19)/chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate the association of corticosteroids on these patients. Methods This retrospective multicenter study screened 5447 confirmed COVID-19 patients hospitalized between Jan 1, 2020 to Apr 18, 2020 in seven centers in China, where the prevalence of chronic HBV infection is moderate to high. Severe patients who had chronic HBV and acute SARS-cov-2 infection were potentially eligible. The diagnosis of chronic HBV infection was based on positive testing for hepatitis B surface antigen (HBsAg) or HBV DNA during hospitalization and a medical history of chronic HBV infection. Severe patients (meeting one of following criteria: respiratory rate > 30 breaths/min; severe respiratory distress; or SpO2 ≤ 93% on room air; or oxygen index < 300 mmHg) with COVID-19/HBV co-infection were identified. The bias of confounding variables on corticosteroids effects was minimized using multivariable logistic regression model and inverse probability of treatment weighting (IPTW) based on propensity score. Results The prevalence of HBV co-infection in COVID-19 patients was 4.1%. There were 105 patients with severe COVID-19/HBV co-infections (median age 62 years, 57.1% male). Fifty-five patients received corticosteroid treatment and 50 patients did not. In the multivariable analysis, corticosteroid therapy (OR, 6.32, 95% CI 1.17–34.24, P = 0.033) was identified as an independent risk factor for 28-day mortality. With IPTW analysis, corticosteroid treatment was associated with delayed SARS-CoV-2 viral RNA clearance (OR, 2.95, 95% CI 1.63–5.32, P < 0.001), increased risk of 28-day and in-hospital mortality (OR, 4.90, 95% CI 1.68–14.28, P = 0.004; OR, 5.64, 95% CI 1.95–16.30, P = 0.001, respectively), and acute liver injury (OR, 4.50, 95% CI 2.57–7.85, P < 0.001). Methylprednisolone dose per day and cumulative dose in non-survivors were significantly higher than in survivors. Conclusions In patients with severe COVID-19/HBV co-infection, corticosteroid treatment may be associated with increased risk of 28-day and in-hospital mortality. |
| first_indexed | 2024-04-11T07:19:22Z |
| format | Article |
| id | doaj.art-ee9c814cb7364048b1f274719b34581d |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-11T07:19:22Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ee9c814cb7364048b1f274719b34581d2022-12-22T04:37:49ZengBMCBMC Infectious Diseases1471-23342022-11-0122111410.1186/s12879-022-07882-6Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter studyMei Meng0Yufeng Chu1Sheng Zhang2Xuechuan Li3Jing Sha4Peng Wang5Yunliang Cui6Meihong Han7Xuan Dong8Wenqing Sun9Zhongfa Zhang10Yunxin Deng11Tao Wang12Djillali Annane13Shouqiang Jia14Dechang Chen15Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Critical Care Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Critical Care Medicine, The 960th Hospital of the PLA Joint Logistics Support ForceDepartment of Infectious Disease, Provincial Hospital Affiliated to Shandong First Medical UniversityTuberculosis and Respiratory Department, Wuhan Infectious Diseases HospitalDepartment of Intensive Care Unit, Shandong Provincial Chest HospitalJinan Infectious Diseases Hospital, Shandong UniversityDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineGeneral Intensive Care Unit, Raymond Poincaré Hospital (APHP), Laboratory of Inflammation and Infection U1173, FHU SEPSIS, RHU RECORDS, University Paris Saclay-Campus UVSQDepartment of Radiology, Jinan People’s Hospital Affiliated to Shandong First Medical UniversityDepartment of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background The impact of corticosteroids on patients with severe coronavirus disease 2019 (COVID-19)/chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate the association of corticosteroids on these patients. Methods This retrospective multicenter study screened 5447 confirmed COVID-19 patients hospitalized between Jan 1, 2020 to Apr 18, 2020 in seven centers in China, where the prevalence of chronic HBV infection is moderate to high. Severe patients who had chronic HBV and acute SARS-cov-2 infection were potentially eligible. The diagnosis of chronic HBV infection was based on positive testing for hepatitis B surface antigen (HBsAg) or HBV DNA during hospitalization and a medical history of chronic HBV infection. Severe patients (meeting one of following criteria: respiratory rate > 30 breaths/min; severe respiratory distress; or SpO2 ≤ 93% on room air; or oxygen index < 300 mmHg) with COVID-19/HBV co-infection were identified. The bias of confounding variables on corticosteroids effects was minimized using multivariable logistic regression model and inverse probability of treatment weighting (IPTW) based on propensity score. Results The prevalence of HBV co-infection in COVID-19 patients was 4.1%. There were 105 patients with severe COVID-19/HBV co-infections (median age 62 years, 57.1% male). Fifty-five patients received corticosteroid treatment and 50 patients did not. In the multivariable analysis, corticosteroid therapy (OR, 6.32, 95% CI 1.17–34.24, P = 0.033) was identified as an independent risk factor for 28-day mortality. With IPTW analysis, corticosteroid treatment was associated with delayed SARS-CoV-2 viral RNA clearance (OR, 2.95, 95% CI 1.63–5.32, P < 0.001), increased risk of 28-day and in-hospital mortality (OR, 4.90, 95% CI 1.68–14.28, P = 0.004; OR, 5.64, 95% CI 1.95–16.30, P = 0.001, respectively), and acute liver injury (OR, 4.50, 95% CI 2.57–7.85, P < 0.001). Methylprednisolone dose per day and cumulative dose in non-survivors were significantly higher than in survivors. Conclusions In patients with severe COVID-19/HBV co-infection, corticosteroid treatment may be associated with increased risk of 28-day and in-hospital mortality.https://doi.org/10.1186/s12879-022-07882-6COVID-19HBVCo-infectionCorticosteroid treatment |
| spellingShingle | Mei Meng Yufeng Chu Sheng Zhang Xuechuan Li Jing Sha Peng Wang Yunliang Cui Meihong Han Xuan Dong Wenqing Sun Zhongfa Zhang Yunxin Deng Tao Wang Djillali Annane Shouqiang Jia Dechang Chen Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study BMC Infectious Diseases COVID-19 HBV Co-infection Corticosteroid treatment |
| title | Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study |
| title_full | Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study |
| title_fullStr | Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study |
| title_full_unstemmed | Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study |
| title_short | Corticosteroid treatment in severe patients with SARS-CoV-2 and chronic HBV co-infection: a retrospective multicenter study |
| title_sort | corticosteroid treatment in severe patients with sars cov 2 and chronic hbv co infection a retrospective multicenter study |
| topic | COVID-19 HBV Co-infection Corticosteroid treatment |
| url | https://doi.org/10.1186/s12879-022-07882-6 |
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