The association between early corticosteroid use and the risk of secondary infections in hospitalized patients with COVID-19: a double-edged sword. Results from the international SCCM discovery viral infection and respiratory illness universal study (VIRUS) COVID-19 registry DOI Creative Commons
Vikas Bansal, Nitesh Jain,

Amos Lal

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 14, 2025

Background Corticosteroids improve survival in hospitalized COVID-19 patients needing supplemental oxygen. However, concern exists about increased risk of secondary infections. This study investigated the impact early corticosteroids use on these Methods Data from Society Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): registry were analyzed for adult patients, stratified by corticosteroid (within 48 h admission). The primary outcome was documented infections, including bacteremia, bacterial pneumonia, empyema, meningitis/encephalitis, septic shock, ventilator-associated pneumonia. Univariate multivariable logistic regression models used to assess association between outcomes. Results Among 17,092 eligible with 13.5% developed at least one infection during hospitalization. Patients receiving older (median 63 years) compared those who did not 60 years), a similar gender distribution (42.5% vs. 44.2% female). Unadjusted analysis revealed higher any (OR 1.93, 95% CI 1.76–2.12). persisted specific infections bacteremia 2.0, 1.58–2.54), pneumonia 1.5, 1.27–1.77), shock 1.67, 1.44–1.93). effect meningitis/encephalitis 0.62, 0.24–1.57) (VAP; OR 1.08, 0.75–1.57) non-significant. Adjusted maintained significance 1.15, 1.02–1.29), 1.43, 1.09–1.88), unknown sources 1.63, 1.31–2.02). Notably, weakened became non-significant 0.98, 0.81–1.20) 0.94, 0.79–1.11), while it significant 0.26, 0.08–0.82). VAP remained 0.87, 0.56–1.34). Conclusion Early overall but varied. Risk notably increased, after adjustment becoming surprisingly reduced noted suggesting complexity effects. Further research is needed understand how influence thereby optimize treatment strategies.

Language: Английский

The association between early corticosteroid use and the risk of secondary infections in hospitalized patients with COVID-19: a double-edged sword. Results from the international SCCM discovery viral infection and respiratory illness universal study (VIRUS) COVID-19 registry DOI Creative Commons
Vikas Bansal, Nitesh Jain,

Amos Lal

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 14, 2025

Background Corticosteroids improve survival in hospitalized COVID-19 patients needing supplemental oxygen. However, concern exists about increased risk of secondary infections. This study investigated the impact early corticosteroids use on these Methods Data from Society Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): registry were analyzed for adult patients, stratified by corticosteroid (within 48 h admission). The primary outcome was documented infections, including bacteremia, bacterial pneumonia, empyema, meningitis/encephalitis, septic shock, ventilator-associated pneumonia. Univariate multivariable logistic regression models used to assess association between outcomes. Results Among 17,092 eligible with 13.5% developed at least one infection during hospitalization. Patients receiving older (median 63 years) compared those who did not 60 years), a similar gender distribution (42.5% vs. 44.2% female). Unadjusted analysis revealed higher any (OR 1.93, 95% CI 1.76–2.12). persisted specific infections bacteremia 2.0, 1.58–2.54), pneumonia 1.5, 1.27–1.77), shock 1.67, 1.44–1.93). effect meningitis/encephalitis 0.62, 0.24–1.57) (VAP; OR 1.08, 0.75–1.57) non-significant. Adjusted maintained significance 1.15, 1.02–1.29), 1.43, 1.09–1.88), unknown sources 1.63, 1.31–2.02). Notably, weakened became non-significant 0.98, 0.81–1.20) 0.94, 0.79–1.11), while it significant 0.26, 0.08–0.82). VAP remained 0.87, 0.56–1.34). Conclusion Early overall but varied. Risk notably increased, after adjustment becoming surprisingly reduced noted suggesting complexity effects. Further research is needed understand how influence thereby optimize treatment strategies.

Language: Английский

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