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10.1210/clinem/dgaa627 http://scihub22266oqcxt.onion/10.1210/clinem/dgaa627 32880390!7499588!32880390     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=32880390&cmd=llinks): Failed to open stream: HTTP request failed! 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Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China |pdf=|usr=}}{{32880390}} gab.com Text Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China JO: J Clin Endocrinol Metab http://www.kidney.de/pget.php?&tw=1&pmid=32880390 #FOAvip BACKGROUND: Systemic corticosteroids are now recommended in many treatment guidelines, although supporting evidence is limited to 1 randomized controlled clinical trial (RECOVERY). OBJECTIVE: To identify whether corticosteroids were beneficial to COVID-19 patients. METHODS: A total of 1514 severe and 249 critical hospitalized COVID-19 patients from 2 medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting [IPTW] and propensity score matching [PSM]) were used to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases. RESULTS: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to the non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in either severe cases (HR = 1.77; 95% CI, 1.08-2.89; P = 0.023), or critical cases (HR = 2.07; 95% CI, 1.08-3.98; P = 0.028). Findings were similar in time-varying Cox analysis. For patients with severe COVID-19 at admission, corticosteroid use was not associated with improved or harmful outcome in either PSM or IPTW analysis. For critical COVID-19 patients at admission, results were consistent with multivariable Cox model analysis. CONCLUSION: Corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality for severe or critical cases in Wuhan. Absence of the beneficial effect in our study in contrast to that observed in the RECOVERY clinical trial may be due to biases in observational data, in particular prescription by indication bias, differences in clinical characteristics of patients, choice of corticosteroid used, timing of initiation of treatment, and duration of treatment. Twit Text FOAVip Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China ????J Clin Endocrinol Metab http://www.kidney.de/pget.php?&tw=1&pmid=32880390 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32880390 #FOAvip English Wikipedia <ref>{{Cite pmid|32880390}}</ref> Systemic Corticosteroids and Mortality in Severe and Critical COVID-19 Patients in Wuhan, China #MMPMID32880390 Wu J; Huang J; Zhu G; Liu Y; Xiao H; Zhou Q; Si X; Yi H; Wang C; Yang D; Chen S; Liu X; Liu Z; Wang Q; Lv Q; Huang Y; Yu Y; Guan X; Li Y; Nirantharakumar K; Cheng K; Peng S; Xiao H J Clin Endocrinol Metab 2020[Dec]; 105 (12): � PMID32880390show ga BACKGROUND: Systemic corticosteroids are now recommended in many treatment guidelines, although supporting evidence is limited to 1 randomized controlled clinical trial (RECOVERY). OBJECTIVE: To identify whether corticosteroids were beneficial to COVID-19 patients. METHODS: A total of 1514 severe and 249 critical hospitalized COVID-19 patients from 2 medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting [IPTW] and propensity score matching [PSM]) were used to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases. RESULTS: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to the non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in either severe cases (HR = 1.77; 95% CI, 1.08-2.89; P = 0.023), or critical cases (HR = 2.07; 95% CI, 1.08-3.98; P = 0.028). Findings were similar in time-varying Cox analysis. For patients with severe COVID-19 at admission, corticosteroid use was not associated with improved or harmful outcome in either PSM or IPTW analysis. For critical COVID-19 patients at admission, results were consistent with multivariable Cox model analysis. CONCLUSION: Corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality for severe or critical cases in Wuhan. Absence of the beneficial effect in our study in contrast to that observed in the RECOVERY clinical trial may be due to biases in observational data, in particular prescription by indication bias, differences in clinical characteristics of patients, choice of corticosteroid used, timing of initiation of treatment, and duration of treatment. |Adrenal Cortex Hormones/therapeutic use[MESH] |Aged[MESH] |Betacoronavirus/*isolation & purification[MESH] |COVID-19[MESH] |Coronavirus Infections/*drug therapy/*mortality/virology[MESH] |Female[MESH] |Hospital Mortality/*trends[MESH] |Hospitalization/*statistics & numerical data[MESH] |Humans[MESH] |Male[MESH] |Middle Aged[MESH] |Pandemics[MESH] |Pneumonia, Viral/*drug therapy/*mortality/virology[MESH] |Prognosis[MESH] |Retrospective Studies[MESH] |SARS-CoV-2[MESH]Systemic Corticosteroids and Mortality in Severe and Critical COVID-19(epmc).pdf DeepDyve Pubget Overpricing