Early Experience With Methylprednisolone on SARS-CoV-2 Infection in the African American Population, a Retrospective Analysis.
COVID-19
acute kidney injury
acute respiratory distress syndrome
methylprednisolone
Journal
Clinical medicine insights. Circulatory, respiratory and pulmonary medicine
ISSN: 1179-5484
Titre abrégé: Clin Med Insights Circ Respir Pulm Med
Pays: United States
ID NLM: 101537753
Informations de publication
Date de publication:
2020
2020
Historique:
received:
04
09
2020
accepted:
19
11
2020
entrez:
6
1
2021
pubmed:
7
1
2021
medline:
7
1
2021
Statut:
epublish
Résumé
Coronavirus disease-19 (COVID-19) is associated with acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) with high mortality rates. In African American (AA) populations, COVID-19 presentations and outcomes are more severe. NIH and Interim WHO guidelines had suggested against the use of corticosteroids unless in clinical trials until the recent publication of the RECOVERY trial. Here, we analyzed the treatment effect of methylprednisolone on patients with AKI and ARDS during the initial 2 months of COVID-19 and detail the learning effect within our institution. Between March 1 and April 30, 2020, 75 AA patients met our inclusion criteria for ARDS and AKI, of which 37 had received corticosteroids. Twenty-eight-day mortality, improvement in PaO Survival in the methylprednisolone group reached 51% at 21 days compared to 29% in the non-corticosteroid group ( In AA COVID-19 positive patients with ARDS and AKI, IV methylprednisolone lowered the incidence of mortality and improved the likelihood of renal and lung function recovery. Further investigation with a randomized control trial of corticosteroids is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Coronavirus disease-19 (COVID-19) is associated with acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS) with high mortality rates. In African American (AA) populations, COVID-19 presentations and outcomes are more severe. NIH and Interim WHO guidelines had suggested against the use of corticosteroids unless in clinical trials until the recent publication of the RECOVERY trial. Here, we analyzed the treatment effect of methylprednisolone on patients with AKI and ARDS during the initial 2 months of COVID-19 and detail the learning effect within our institution.
METHODS
METHODS
Between March 1 and April 30, 2020, 75 AA patients met our inclusion criteria for ARDS and AKI, of which 37 had received corticosteroids. Twenty-eight-day mortality, improvement in PaO
RESULTS
RESULTS
Survival in the methylprednisolone group reached 51% at 21 days compared to 29% in the non-corticosteroid group (
CONCLUSION
CONCLUSIONS
In AA COVID-19 positive patients with ARDS and AKI, IV methylprednisolone lowered the incidence of mortality and improved the likelihood of renal and lung function recovery. Further investigation with a randomized control trial of corticosteroids is warranted.
Identifiants
pubmed: 33402859
doi: 10.1177/1179548420980699
pii: 10.1177_1179548420980699
pmc: PMC7745550
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1179548420980699Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Références
Nat Rev Nephrol. 2015 Sep;11(9):509-10
pubmed: 26122731
JAMA. 2020 Oct 6;324(13):1307-1316
pubmed: 32876695
Health Aff (Millwood). 2020 Jul;39(7):1253-1262
pubmed: 32437224
Eur J Endocrinol. 2020 Jul;183(1):G9-G15
pubmed: 32380474
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Clin Infect Dis. 2021 May 4;72(9):e373-e381
pubmed: 32785710
J Intensive Care. 2018 Aug 24;6:53
pubmed: 30155260
JAMA. 2020 Oct 6;324(13):1298-1306
pubmed: 32876689
Cell Discov. 2020 May 4;6:31
pubmed: 32377375
Am J Respir Crit Care Med. 2018 Mar 15;197(6):757-767
pubmed: 29161116
Eur J Clin Microbiol Infect Dis. 2021 Apr;40(4):761-769
pubmed: 33083917
Orv Hetil. 2020 Apr 01;161(17):704-709
pubmed: 32324366
J Am Soc Nephrol. 2020 Aug;31(8):1683-1687
pubmed: 32371536
Cureus. 2020 Apr 6;12(4):e7560
pubmed: 32269893
Ann Intensive Care. 2019 Jul 1;9(1):74
pubmed: 31264042
Br J Anaesth. 2020 Aug;125(2):e255-e257
pubmed: 32423609
JAMA. 2020 Oct 6;324(13):1330-1341
pubmed: 32876694
Intensive Care Med. 2020 May;46(5):846-848
pubmed: 32125452
Clin J Am Soc Nephrol. 2014 Aug 7;9(8):1347-53
pubmed: 24875195
J Health Soc Behav. 2018 Sep;59(3):411-428
pubmed: 29949724
Kidney Int. 2020 May;97(5):824-828
pubmed: 32204907
Clin Chem Lab Med. 2020 Jun 25;58(7):1029-1036
pubmed: 32406381
Ann Med Interne (Paris). 1988;139(2):100-2
pubmed: 3293497
Am J Physiol Lung Cell Mol Physiol. 2020 Jun 1;318(6):L1244-L1247
pubmed: 32401670
Mil Med Res. 2020 May 5;7(1):22
pubmed: 32370766
Clin Infect Dis. 2020 Nov 19;71(16):2114-2120
pubmed: 32427279
BMJ. 2020 Mar 26;368:m1091
pubmed: 32217556
Lancet Respir Med. 2020 May;8(5):475-481
pubmed: 32105632
Open Forum Infect Dis. 2020 Sep 12;7(10):ofaa421
pubmed: 33072814