Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19

{ 'indexed': {'date-parts': [[2022, 1, 21]], 'date-time': '2022-01-21T20:11:44Z', 'timestamp': 1642795904653}, 'reference-count': 29, 'publisher': 'Public Library of Science (PLoS)', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2022, 1, 21]], 'date-time': '2022-01-21T00:00:00Z', 'timestamp': 1642723200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['www.plosone.org'], 'crossmark-restriction': False}, 'short-container-title': ['PLoS ONE'], 'abstract': '<jats:sec id="sec001">\n' '<jats:title>Objective</jats:title>\n' '<jats:p>To describe the impact of different doses of corticosteroids on the evolution of ' 'patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism ' 'of these drugs at higher doses.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec002">\n' '<jats:title>Methods</jats:title>\n' '<jats:p>Observational study using data collected from the SEMI-COVID-19 Registry. We ' 'evaluated the epidemiological, radiological and analytical scenario between patients treated ' 'with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development ' 'of complications. The primary endpoint was all-cause in-hospital mortality according to use ' 'of corticosteroids megadoses.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec003">\n' '<jats:title>Results</jats:title>\n' '<jats:p>Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, ' '2,216 (46%) specifically received megadoses. Age was a factor that differed between those who ' 'received megadoses therapy versus those who did not in a significant manner (69 years [IQR ' '59–79] vs 73 years [IQR 61–83]; <jats:italic>p</jats:italic> &lt; .001). Radiological and ' 'analytical findings showed a higher use of megadoses therapy among patients with an ' 'interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the ' 'univariate study it appears that steroid use is associated with increased mortality (OR 2.07 ' '95% CI 1.91–2.24 p &lt; .001) and megadose use with increased survival (OR 0.84 95% CI ' '0.75–0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that ' 'the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32–1.80; p ' '&lt; .001). There is no difference between megadoses and low-dose (p .298). Although, there ' 'are differences in the use of megadoses versus low-dose in terms of complications, mainly ' 'infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI ' '0.71–0.95; p &lt; .001 and OR 0.80 95% CI 0.65–0.97; p &lt; .001) respectively.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec004">\n' '<jats:title>Conclusion</jats:title>\n' '<jats:p>There is no difference in mortality with megadoses versus low-dose, but there is a ' 'lower incidence of infectious complications with glucocorticoid megadoses.</jats:p>\n' '</jats:sec>', 'DOI': '10.1371/journal.pone.0261711', 'type': 'journal-article', 'created': {'date-parts': [[2022, 1, 21]], 'date-time': '2022-01-21T19:40:51Z', 'timestamp': 1642794051000}, 'page': 'e0261711', 'update-policy': 'http://dx.doi.org/10.1371/journal.pone.corrections_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': ['Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19'], 'prefix': '10.1371', 'volume': '17', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-3537-8607', 'authenticated-orcid': True, 'given': 'Cristina', 'family': 'Lavilla Olleros', 'sequence': 'first', 'affiliation': []}, {'given': 'Cristina', 'family': 'Ausín García', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Alejandro David', 'family': 'Bendala Estrada', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ana', 'family': 'Muñoz', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-6329-0311', 'authenticated-orcid': True, 'given': 'Philip Erick', 'family': 'Wikman Jogersen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ana', 'family': 'Fernández Cruz', 'sequence': 'additional', 'affiliation': []}, {'given': 'Vicente', 'family': 'Giner Galvañ', 'sequence': 'additional', 'affiliation': []}, {'given': 'Juan Antonio', 'family': 'Vargas', 'sequence': 'additional', 'affiliation': []}, {'given': 'José Miguel', 'family': 'Seguí Ripoll', 'sequence': 'additional', 'affiliation': []}, {'given': 'Manuel', 'family': 'Rubio-Rivas', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rodrigo', 'family': 'Miranda Godoy', 'sequence': 'additional', 'affiliation': []}, {'given': 'Luis', 'family': 'Mérida Rodrigo', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-0578-7474', 'authenticated-orcid': True, 'given': 'Eva', 'family': 'Fonseca Aizpuru', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Francisco', 'family': 'Arnalich Fernández', 'sequence': 'additional', 'affiliation': []}, {'given': 'Arturo', 'family': 'Artero', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jose', 'family': 'Loureiro Amigo', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-3691-1637', 'authenticated-orcid': True, 'given': 'Gema María', 'family': 'García García', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-0151-5420', 'authenticated-orcid': True, 'given': 'Luis', 'family': 'Corral Gudino', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-7588-9148', 'authenticated-orcid': True, 'given': 'Jose', 'family': 'Jiménez Torres', 'sequence': 'additional', 'affiliation': []}, {'given': 'José-Manuel', 'family': 'Casas-Rojo', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Jesús', 'family': 'Millán Núñez-Cortés', 'sequence': 'additional', 'affiliation': []}, { 'name': 'On behalf of the SEMI-COVID-19 Network', 'sequence': 'additional', 'affiliation': []}], 'member': '340', 'published-online': {'date-parts': [[2022, 1, 21]]}, 'reference': [ { 'issue': '8', 'key': 'pone.0261711.ref001', 'doi-asserted-by': 'crossref', 'first-page': '727', 'DOI': '10.1056/NEJMoa2001017', 'article-title': 'A Novel Coronavirus from Patients with Pneumonia in China, 2019', 'volume': '382', 'author': 'N Zhu', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'key': 'pone.0261711.ref002', 'unstructured': 'S. M. of Health. Clinical management of patients with infection by the ' 'new coronavirus COVID-19 (Spanish Ministry of Health and Social Policy, ' 'March 2020. 1395. ' 'https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Protocolo_manejo_clinico_ah_COVID-19.pdf ' '(accessed March 28th, 2021).'}, { 'issue': '5', 'key': 'pone.0261711.ref003', 'doi-asserted-by': 'crossref', 'first-page': '405', 'DOI': '10.1016/j.healun.2020.03.012', 'article-title': 'COVID-19 illness in native and immunosuppressed states: A ' 'clinical-therapeutic staging proposal', 'volume': '39', 'author': 'HK Siddiqi', 'year': '2020', 'journal-title': 'J Heart Lung Transplant'}, { 'issue': '7', 'key': 'pone.0261711.ref004', 'doi-asserted-by': 'crossref', 'first-page': '934', 'DOI': '10.1001/jamainternmed.2020.0994', 'article-title': 'Risk Factors Associated With Acute Respiratory Distress Syndrome and ' 'Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, ' 'China', 'volume': '180', 'author': 'C Wu', 'year': '2020', 'journal-title': 'JAMA Intern Med'}, { 'issue': '10223', 'key': 'pone.0261711.ref005', 'doi-asserted-by': 'crossref', 'first-page': '473', 'DOI': '10.1016/S0140-6736(20)30317-2', 'article-title': 'Clinical evidence does not support corticosteroid treatment for ' '2019-nCoV lung injury', 'volume': '395', 'author': 'CD Russell', 'year': '2020', 'journal-title': 'Lancet'}, { 'issue': '8', 'key': 'pone.0261711.ref006', 'doi-asserted-by': 'crossref', 'first-page': '480', 'DOI': '10.1016/j.rce.2020.07.003', 'article-title': 'Clinical characteristics of patients hospitalized with COVID-19 in ' 'Spain: Results from the SEMI-COVID-19 Registry. Características ' 'clínicas de los pacientes hospitalizados con COVID-19 en España: ' 'resultados del Registro SEMI-COVID-19', 'volume': '220', 'author': 'JM Casas-Rojo', 'year': '2020', 'journal-title': 'Rev Clin Esp'}, { 'key': 'pone.0261711.ref007', 'unstructured': 'World Health Organization. Clinical management of severe acute ' 'respiratory infection when novel coronavirus (no) infection is suspected ' '(WHO/2019-nCoV/clinical/2020.4). Updated 13 Mar 2020. ' 'www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-whennovel-coronavirus-(ncov)-infection-is-suspected ' '(accessed March 28th, 2021).'}, { 'issue': '8', 'key': 'pone.0261711.ref008', 'doi-asserted-by': 'crossref', 'first-page': '693', 'DOI': '10.1056/NEJMoa2021436', 'article-title': 'Dexamethasone in Hospitalized Patients with Covid-19', 'volume': '384', 'author': 'RECOVERY Collaborative Group', 'year': '2021', 'journal-title': 'N Engl J Med'}, { 'issue': '11', 'key': 'pone.0261711.ref009', 'doi-asserted-by': 'crossref', 'first-page': '3408', 'DOI': '10.1002/art.20583', 'article-title': 'Glucocorticoids in the treatment of rheumatic diseases: an update on ' 'the mechanisms of action', 'volume': '50', 'author': 'F Buttgereit', 'year': '2004', 'journal-title': 'Arthritis Rheum'}, { 'issue': '9', 'key': 'pone.0261711.ref010', 'doi-asserted-by': 'crossref', 'first-page': 'e0239401', 'DOI': '10.1371/journal.pone.0239401', 'article-title': 'Second week methyl-prednisolone pulses improve prognosis in patients ' 'with severe coronavirus disease 2019 pneumonia: An observational ' 'comparative study using routine care data', 'volume': '15', 'author': 'G Ruiz-Irastorza', 'year': '2020', 'journal-title': 'PLoS One'}, { 'issue': '1', 'key': 'pone.0261711.ref011', 'doi-asserted-by': 'crossref', 'first-page': 'e0243964', 'DOI': '10.1371/journal.pone.0243964', 'article-title': 'High-dose corticosteroid pulse therapy increases the survival rate in ' 'COVID-19 patients at risk of hyper-inflammatory response', 'volume': '16', 'author': 'MÁ López Zúñiga', 'year': '2021', 'journal-title': 'PLoS One'}, { 'issue': '1', 'key': 'pone.0261711.ref012', 'doi-asserted-by': 'crossref', 'first-page': '38', 'DOI': '10.1016/j.tips.2018.11.002', 'article-title': 'Non-genomic Effects of Glucocorticoids: An Updated View', 'volume': '40', 'author': 'RA Panettieri', 'year': '2019', 'journal-title': 'Trends Pharmacol Sci'}, { 'issue': '8', 'key': 'pone.0261711.ref013', 'doi-asserted-by': 'crossref', 'first-page': '1470', 'DOI': '10.1093/rheumatology/keu148', 'article-title': 'Glucocorticoids and irreversible damage in patients with systemic lupus ' 'erythematosus', 'volume': '53', 'author': 'I Ruiz-Arruza', 'year': '2014', 'journal-title': 'Rheumatology (Oxford)'}, { 'issue': '16', 'key': 'pone.0261711.ref014', 'doi-asserted-by': 'crossref', 'first-page': '2199', 'DOI': '10.1093/cid/ciaa576', 'article-title': 'Risk Factors for Severe Disease and Efficacy of Treatment in Patients ' 'Infected With COVID-19: A Systematic Review, Meta-Analysis, and ' 'Meta-Regression Analysis', 'volume': '71', 'author': 'JJY Zhang', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'issue': 'sup4', 'key': 'pone.0261711.ref015', 'doi-asserted-by': 'crossref', 'first-page': '18', 'DOI': '10.1080/00325481.2020.1823760', 'article-title': 'Men and COVID-19: the aftermath', 'volume': '132', 'author': 'A White', 'year': '2020', 'journal-title': 'Postgrad Med'}, { 'issue': '23', 'key': 'pone.0261711.ref016', 'doi-asserted-by': 'crossref', 'first-page': '2291', 'DOI': '10.1056/NEJMc2031364', 'article-title': 'Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host', 'volume': '383', 'author': 'B Choi', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '2', 'key': 'pone.0261711.ref017', 'doi-asserted-by': 'crossref', 'first-page': '340', 'DOI': '10.1093/cid/ciaa863', 'article-title': 'COVID-19 in Immunocompromised Hosts: What We Know So Far', 'volume': '72', 'author': 'M Fung', 'year': '2021', 'journal-title': 'Clin Infect Dis'}, { 'issue': '7', 'key': 'pone.0261711.ref018', 'doi-asserted-by': 'crossref', 'first-page': '934', 'DOI': '10.1001/jamainternmed.2020.0994', 'article-title': 'Risk Factors Associated With Acute Respiratory Distress Syndrome and ' 'Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, ' 'China', 'volume': '180', 'author': 'C Wu', 'year': '2020', 'journal-title': 'JAMA Intern Med'}, { 'issue': '1', 'key': 'pone.0261711.ref019', 'doi-asserted-by': 'crossref', 'first-page': '20', 'DOI': '10.1056/NEJMoa2030340', 'article-title': 'Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia', 'volume': '384', 'author': 'C Salama', 'year': '2021', 'journal-title': 'N Engl J Med'}, { 'key': 'pone.0261711.ref020', 'article-title': 'Use of Baricitinib in Patients with Moderate and Severe COVID-19', 'author': 'BK Titanji', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'issue': '8', 'key': 'pone.0261711.ref021', 'doi-asserted-by': 'crossref', 'first-page': '843', 'DOI': '10.1002/phar.2438', 'article-title': 'Baricitinib: A Review of Pharmacology, Safety, and Emerging Clinical ' 'Experience in COVID-19', 'volume': '40', 'author': 'SCJ Jorgensen', 'year': '2020', 'journal-title': 'Pharmacotherapy'}, { 'issue': '19', 'key': 'pone.0261711.ref022', 'doi-asserted-by': 'crossref', 'first-page': '1787', 'DOI': '10.1056/NEJMoa2001282', 'article-title': 'A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe ' 'Covid-19', 'volume': '382', 'author': 'B Cao', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '3', 'key': 'pone.0261711.ref023', 'doi-asserted-by': 'crossref', 'first-page': '587', 'DOI': '10.1007/s11239-020-02228-y', 'article-title': 'COVID-19 and ischemic stroke: a systematic review and meta-summary of ' 'the literature', 'volume': '50', 'author': 'YK Tan', 'year': '2020', 'journal-title': 'J Thromb Thrombolysis'}, { 'issue': '23', 'key': 'pone.0261711.ref024', 'doi-asserted-by': 'crossref', 'first-page': '2033', 'DOI': '10.1182/blood.2020006000', 'article-title': 'COVID-19 and its implications for thrombosis and anticoagulation', 'volume': '135', 'author': 'JM Connors', 'year': '2020', 'journal-title': 'Blood'}, { 'issue': '2', 'key': 'pone.0261711.ref025', 'doi-asserted-by': 'crossref', 'first-page': '266', 'DOI': '10.1016/j.jinf.2020.05.046', 'article-title': 'Co-infections in people with COVID-19: a systematic review and ' 'meta-analysis', 'volume': '81', 'author': 'L Lansbury', 'year': '2020', 'journal-title': 'J Infect'}, { 'issue': '9', 'key': 'pone.0261711.ref026', 'doi-asserted-by': 'crossref', 'first-page': 'e01168', 'DOI': '10.1128/AAC.01168-20', 'article-title': 'A Retrospective Controlled Cohort Study of the Impact of Glucocorticoid ' 'Treatment in SARS-CoV-2 Infection Mortality', 'volume': '64', 'author': 'A Fernández-Cruz', 'year': '2020', 'journal-title': 'Antimicrob Agents Chemother'}, { 'issue': '4', 'key': 'pone.0261711.ref027', 'first-page': '159', 'article-title': 'Effectiveness of corticoid pulses in patients with cytokine storm ' 'syndrome induced by SARS-CoV-2 infection', 'volume': '155', 'author': 'JL Callejas Rubio', 'year': '2020', 'journal-title': 'Med Clin (Barc)'}, { 'key': 'pone.0261711.ref028', 'article-title': 'Methylprednisolone as Adjunctive Therapy for Patients Hospitalized With ' 'COVID-19 (Metcovid): A Randomised, Double-Blind, Phase IIb, ' 'Placebo-Controlled Trial', 'author': 'CMP Jeronimo', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'key': 'pone.0261711.ref029', 'unstructured': 'Glucocorticoids in COVID-19 (CORTIVID). ' 'https://clinicaltrials.gov/ct2/show/NCT04438980 (accessed March 28th, ' '2021).'}], 'container-title': ['PLOS ONE'], 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://dx.plos.org/10.1371/journal.pone.0261711', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 1, 21]], 'date-time': '2022-01-21T19:41:24Z', 'timestamp': 1642794084000}, 'score': 1, 'subtitle': [], 'editor': [{'given': 'Aleksandar R.', 'family': 'Zivkovic', 'sequence': 'first', 'affiliation': []}], 'short-title': [], 'issued': {'date-parts': [[2022, 1, 21]]}, 'references-count': 29, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2022, 1, 21]]}}, 'URL': 'http://dx.doi.org/10.1371/journal.pone.0261711', 'relation': {}, 'ISSN': ['1932-6203'], 'issn-type': [{'value': '1932-6203', 'type': 'electronic'}], 'subject': ['Multidisciplinary'], 'published': {'date-parts': [[2022, 1, 21]]}}