قانعی, مصطفی ، سلیمانی, مسعود ، قزوینی, علی ، غزاله, امیرحسین ، ستاره دان, سیدامین ، سعادت, سیدحسن ، قبادی مراللو, حسن ، حسینی نیا, سعید ، صمدی تکلدانی, علی حسین ، ایمانی, یوسف (1400) اثربخشی درمان با کورتیکواستروئیدها در بیماران مبتلا به SARS-CoV-2 متوسط تا شدید عفونت: چند مرکزی ، تصادفی ، برچسب باز آزمایش. Respiratory research ــ 22 (1). ص.ص.1-14. شاپا 1465-993X
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عنوان انگليسی
The efficacy of corticosteroids therapy in patients with moderate to severe SARS-CoV-2 infection: a multicenter, randomized, open-label trial
خلاصه انگلیسی
Background We performed a multicenter, randomized open-label trial in patients with moderate to severe Covid-19 treated with a range of possible treatment regimens. Methods: Patients were randomly assigned to one of three regimen groups at a ratio of 1:1:1. The primary outcome of this study was admission to the intensive care unit. Secondary outcomes were intubation, in-hospital mortality, time to clinical recovery, and length of hospital stay (LOS). Between April 13 and August 9, 2020, a total of 336 patients were randomly assigned to receive one of the 3 treatment regimens including group I (hydroxychloroquine stat, prednisolone, azithromycin and naproxen; 120 patients), group II (hydroxychloroquine stat, azithromycin and naproxen; 116 patients), and group III (hydroxychloroquine and lopinavir/ritonavir (116 patients). The mean LOS in patients receiving prednisolone was 5.5 in the modified intention-to-treat (mITT) population and 4.4 days in the per-protocol (PP) population compared with 6.4 days (mITT population) and 5.8 days (PP population) in patients treated with Lopinavir/Ritonavir. Results The mean LOS was significantly lower in the mITT and PP populations who received prednisolone compared with populations treated with Lopinavir/Ritonavir (p = 0.028; p = 0.0007). We observed no significant differences in the number of deaths, ICU admission, and need for mechanical ventilation between the Modified ITT and per-protocol populations treated with prednisolone and Lopinavir/Ritonavir, although these outcomes were better in the arm treated with prednisolone. The time to clinical recovery was similar in the modified ITT and per-protocol populations treated with prednisolone, lopinavir/ritonavir, and azithromycin (P = 0.335; P = 0.055; p = 0.291; p = 0.098). Conclusion The results of the present study show that therapeutic regimen (regimen I) with low dose prednisolone was superior to other regimens in shortening the length of hospital stay in patients with moderate to severe COVID-19. The steroid sparing effect may be utilized to increase the effectiveness of corticosteroids in the management of diabetic patients by decreasing the dosage.
نوع سند : | مقاله |
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زبان سند : | انگلیسی |
نویسنده مسئول : | مصطفی قانعی |
نویسنده : | مسعود سلیمانی |
نویسنده : | علی قزوینی |
نویسنده : | امیرحسین غزاله |
نویسنده : | سیدامین ستاره دان |
نویسنده : | سیدحسن سعادت |
نویسنده : | حسن قبادی مراللو |
نویسنده : | سعید حسینی نیا |
نویسنده : | علی حسین صمدی تکلدانی |
نویسنده : | یوسف ایمانی |
ضریب تاثیر و نمایه مجلات: | IF: 5.631 Indexed in: ISI, PubMed/Medline, Scopus, Embase |
کلیدواژه ها (انگلیسی): | COVID-19, Corticosteroids, Low dose prednisolone, Anti-infammatory drugs |
موضوعات : | WF سیستم تنفسی |
بخش های دانشگاهی : | دانشكده پزشكي > گروه داخلی ، قلب ، عفونی |
کد شناسایی : | 14713 |
ارائه شده توسط : | دکتر علی حسین صمدی تکلدانی |
ارائه شده در تاریخ : | 03 مهر 1400 13:31 |
آخرین تغییر : | 03 مهر 1400 13:31 |
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