Abstract
Introduction Steroids have theoretically seems useful in critically ill patients of COVID-19. However the time of starting steroid and dose remains a matter of concern due to still emerging evidences and wide-ranging concerns of benefits and harms. We did a retrospective record analysis in an apex teaching hospital ICU setting to explore this concern.
Methodology 45 adults age ≥18 years with nasopharyngeal swab PCR-confirmed SARS-CoV- 2 infection with ARDS admitted to ICU in between 20th March,2020 to 15th July 2020 were included in chart review. We did a bivariate analysis of age, comorbidity, infections, severity of disease, timing /dose(appropriate) steroid and presence of infection on survival. In the next step we performed a Bayesian Exact regression to understand the adjusted effect of early appropriate steroid on survival in the presence of age and infections as probable confounder.
Results Bivariate analysis showed the statistically significant effect of age <60 years and steroid dose (early and classified by disease severity) had a favourable effect on outcome. Further Early Pulse Steroid (EPS) amongst the more severe subgroup was found to be significantly associated with better survival.
Conclusion High dose steroids (≥500 mg MPS) if given early in the course of disease to COVID19 critically ill patients (P/F<150) can significantly reduce mortality and are not associated with increased infections.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
we did not receive any funding for this project.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
This retrospective chart review study is part of study titled Predictors of severity in COVID 19 infected patients: Observational Chart review. Institutional Human Ethics Committee (IHEC) approved the protocol vide LOP Number IHEC-LOP/2020/IM0281, dated 15/07/2020.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
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Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
Data Availability
We have submitted data in the supplement.