Effect of Methylprednisolone on Mortality and Clinical Courses in Patients with Severe CoVID-19: A Propensity Score Matching Analysis  

作　　者：Xiaoyan Li Xin Yuan Zhe Xu Lei Shi Lei Huang Xuechun Lu Junliang Fu 

机构地区：[1]Medical School of Chinese PLA,Beijing 100853,China [2]Senior Department of Infectious Diseases,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China [3]National Clinical Research Center for Infectious Diseases,Beijing 100039,China [4]Department of Hematology,the Second Medical Center of Chinese PLA General Hospital,Beijing 100853,China.

出　　处：《Infectious Diseases & Immunity》2023年第1期20-28,共9页感染性疾病与免疫（英文）

基　　金：National Key R&D Program of China(2020YFC0860900);Emergency Key Program of Guangzhou Laboratory(EKPG21-30-4).

摘　　要：Background Whether methylprednisolone therapy can reduce the mortality rate of patients with severe coronavirus disease 2019(COVID-19)remains controversial,and its effects on the length of hospital stay and virus shedding time are also unknown.This retrospective study investigates the previous issues to provide more evidence for methylprednisolone treatment in severe COVID-19.Methods This retrospective study included 563 of 4827 patients with confirmed COVID-19 admitted to Wuhan Huoshenshan Hospital or Wuhan Guanggu Hospital between February 3,2020 and March 30,2020 who met the screening criteria.The participants’epidemiological and demographic data,comorbidities,laboratory test results,treatments,outcomes,and vital clinical time points were extracted from electronic medical records.The primary outcome was in-hospital death,and the secondary outcomes were 2 clinical courses:length from admission to viral clearance and discharge.Univariate and multivariate logistic or linear regression analyses were used to assess the role of methylprednisolone in different outcomes.Propensity score matching was performed to control for confounding factors.Results Of the 563 patients who met the screening criteria and were included in the subsequent analysis,138 were included in the methylprednisolone group and 425 in the nonmethylprednisolone group.The in-hospital death rate between the methylprednisolone and nonmethylprednisolone groups showed a significant difference(23.91%vs.1.65%,P<0.001),which was maintained after propensity score matching(13.98%vs.5.38%,P=0.048).However,univariate logistic analysis in the matched groups showed that methylprednisolone treatment(odds ratio[OR],5.242;95%confidence interval[CI],0.802 to 34.246;P=0.084)was not a risk factor for in-hospital death in severe patients.Further multivariate logistic regression analysis found comorbidities(OR,3.327;95%CI,1.702 to 6.501;P<0.001),lower lymphocyte count(OR,0.076;95%CI,0.012 to 0.461;P=0.005),higher lactate dehydrogenase(LDH)levels(OR,1.008;95%CI,1.003 t

关 键 词：COVID-19 Clinical courses In-hospital death METHYLPREDNISOLONE SARS-CoV-2 

分 类 号：R563.1[医药卫生—呼吸系统]