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

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Infectious Diseases & Immunity 2023年第1期3卷 20-28页

作者： Xiaoyan Li Xin Yuan Zhe Xu Lei Shi Lei Huang Xuechun Lu Junliang Fu Medical School of Chinese PLA Beijing 100853China Senior Department of Infectious Diseases the Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China National clinical Research Center for Infectious Diseases Beijing 100039China Department of Hematology the Second Medical Center of Chinese PLA General HospitalBeijing 100853China.

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 to

关键词： COVID-19 Clinical courses In-hospital death Methylprednisolone SARS-CoV-2

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Discussion on the Cultivation of Scientific Research Ability of Postgraduates Majoring in Medicine

Discussion on the Cultivation of Scientific Research Ability...

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作者： Liang LIANG Li-ye HE Bao-ji CHEN Department of Ophthalmology Yichang Central Hospital

In order to further promote the development of medical education in China, China officially promulgated the "Guidelines for the Training of Postgraduate Students in clinical Medicine" in 2015, and formulated the "four-in-one" training program. The clinical skills and clinical knowledge of professional degree graduates have been developed, but their research capabilities are obviously lacking. Therefore, how to improve the scientific research ability of professional degree graduate students is an urgent problem to be solved in medical graduate education. This article aims to explore some of the problems faced by medical graduate education and their reflections.

关键词： Education medicine Scientific research Medical students Clinical courses

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