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

Lavilla Olleros et al., PLOS ONE, doi:10.1371/journal.pone.0261711
Jan 2022  
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Mortality 36% Improvement Relative Risk HCQ  Lavilla Olleros et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 14,921 patients in Spain Lower mortality with HCQ (p<0.000001) c19hcq.org Lavilla Olleros et al., PLOS ONE, January 2022 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19hcq.org
Retrospective 14,921 hospitalized patients in Spain, showing lower mortality with HCQ treatment.
risk of death, 36.2% lower, RR 0.64, p < 0.001, treatment 2,285 of 12,772 (17.9%), control 774 of 2,149 (36.0%), NNT 5.5, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lavilla Olleros et al., 21 Jan 2022, retrospective, Spain, peer-reviewed, 22 authors.
This PaperHCQAll
Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
Cristina Lavilla Olleros, Cristina Ausín García, Alejandro David Bendala Estrada, Ana Muñoz, Philip Erick Wikman Jogersen, Ana Fernández Cruz, Vicente Giner Galvañ, Juan Antonio Vargas, José Miguel Seguí Ripoll, Manuel Rubio-Rivas, Rodrigo Miranda Godoy, Luis Mérida Rodrigo, Eva Fonseca Aizpuru, Francisco Arnalich Fernández, Arturo Artero, Jose Loureiro Amigo, Gema María García García, Luis Corral Gudino, Jose Jiménez Torres, José-Manuel Casas-Rojo, Jesús Millán Núñez-Cortés
PLOS ONE, doi:10.1371/journal.pone.0261711
Objective 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. Methods 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.
References
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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. 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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]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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