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Retrospective analysis of anti-inflammatory therapies during the first wave of COVID-19 at a community hospital

World Journal of Critical Care Medicine 2021年第5期10卷 244-259页

作者： Jose I Iglesias Andrew V Vassallo Jesse B Sullivan Yasmine Elbaga Vishal V Patel Nikunjkumar Patel Lydia Ayad Payam Benson Marina Pittiglio Emad Gobran Alexander Clark Wajahat Khan kaliope damalas Rajesh Mohan Satyendra P Singh Department of Critical Care Community Medical CenterToms RiverNJ 08757United States Department of Nephrology Community Medical CenterToms RiverNJ 08757United States Department of Nephrology Jersey Shore University Medical CenterHackensack Meridian School of Medicine at Seton HallNeptuneNJ 07753United States Department of Pharmacy Community Medical CenterToms RiverNJ 08757United States Fairleigh Dickinson University School of Pharmacy&Health Sciences Fairleigh Dickinson UniversityFlorham ParkNJ 07932United States Department of Pharmancy Monmouth Medical Center Southern CampusLakewoodNJ 08701United States Department of Medicine Community Medical CenterToms RiverNJ 08757United States Department of Cardiology Monmouth Medical Center Southern CampusLakewoodNJ 08701United States Department of Medicine Monmouth Medical Center Southern CampusLakewoodNJ 08701United States

BACKGROUND Our understanding of the severe acute respiratory syndrome coronavirus 2 has evolved since the first reported cases in December 2019,and a greater emphasis has been placed on the hyper-inflammatory response in severely ill *** purpose of this study was to determine risk factors for mortality and the impact of anti-inflammatory therapies on *** To determine the impact of various therapies on outcomes in severe coronavirus disease 2019 patients with a focus on anti-inflammatory and immune-modulating *** A retrospective analysis was conducted on 261 patients admitted or transferred to the intensive care unit in two community hospitals between March 12,2020 and June 17,*** 167 patients received glucocorticoid(GC)*** patients received GC alone,94 received GC and tocilizumab,28 received tocilizumab monotherapy,and 66 received no anti-inflammatory *** Patient survival was associated with GC use,either alone or with tocilizumab,and decreased vasopressor *** administration of GC was found to decrease the survival benefit of GC *** difference in survival was found with varying anticoagulant doses,convalescent plasma,tocilizumab monotherapy;prone ventilation,hydroxychloroquine,azithromycin,or intravenous ascorbic acid *** This analysis demonstrated the survival benefit associated with anti-inflammatory therapy of GC,with or without tocilizumab,with the combination providing the most *** studies are needed to assess the optimal timing of anti-inflammatory therapy initiation.

关键词： COVID-19 Corticosteroids Intensive care unit Methylprednisolone Tociluzimab Anti-inflammatory

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