Evidence map›Paper›PMID 37038264›Full record

ArticleThe Korean journal of internal medicine2023

Corticosteroid outcome may be dependent of duration of use in severe COVID-19.

Jin Hyoung Kim, Yong Sub Na, Song-I Lee, Youn Young Moon, Beom Seuk Hwang, Ae-Rin Baek, Won-Young Kim, Bo Young Lee, Gil Myeong Seong, Moon Seong Baek

Open access · goldAbstract read
In one paragraph

Article in The Korean journal of internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 1 country.

Jin Hyoung KimDivision of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Yong Sub NaDepartment of Pulmonology and Critical Care Medicine, Chosun University Hospital, Gwangju, Korea.
Song-I LeeDepartment of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea.
Youn Young MoonDepartment of Applied Statistics, Chung-Ang University, Seoul, Korea.
Beom Seuk HwangDepartment of Applied Statistics, Chung-Ang University, Seoul, Korea.
Ae-Rin BaekDivision of Allergy and Pulmonology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Won-Young KimDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Bo Young LeeDivision of Allergy and Respiratory Diseases, Soonchunhyang University Hospital, Seoul, Korea.
Gil Myeong SeongDepartment of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea.
Moon Seong BaekDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Chung-Ang University · KRChung-Ang University Hospital · KRChosun University Hospital · KRChungnam National University Hospital · KRJeju National University · KRSoonchunhyang University · KRSoonchunhyang University Hospital Seoul · KRUlsan College · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsFor patients hospitalized with coronavirus disease 2019 (COVID-19) who require supplemental oxygen, the evidence of the optimal duration of corticosteroid is limited. This study aims to identify whether long-term use of corticosteroids is associated with decreased mortality.

methodsBetween February 10, 2020 and October 31, 2021, we analyzed consecutive hospitalized patients with COVID-19 with severe hypoxemia. The patients were divided into short-term (≤ 14 days) and long-term (> 14 days) corticosteroid users. The primary outcome was 60-day mortality. We performed propensity score (PS) analysis to mitigate the effect of confounders and conducted Kaplan-Meier curve analysis.

resultsThere were 141 (52%) short-term users and 130 (48%) long-term corticosteroid users. The median age was 68 years and the median PaO2/FiO2 at admission was 158. Of the patients, 40.6% required high-flow nasal cannula, 48.3% required mechanical ventilation, and 11.1% required extracorporeal membrane oxygenation. The overall 60-day mortality rate was 23.2%, and that of patients with hospital-acquired pneumonia (HAP) was 22.9%. The Kaplan-Meier curve for 60- day survival in the PS-matched cohort showed that corticosteroid for > 14 days was associated with decreased mortality (p = 0.0033). There were no significant differences in bacteremia and HAP between the groups. An adjusted odds ratio for the risk of 60-day mortality in short-term users was 5.53 (95% confidence interval, 1.90-18.26; p = 0.003).

conclusionFor patients with severe COVID-19, long-term use of corticosteroids was associated with decreased mortality, with no increase in nosocomial complications. Corticosteroid use for > 14 days can benefit patients with severe COVID-19.

Indexed as

COVID-19Adrenal Cortex HormonesAgedHospitalizationHumansKaplan-Meier EstimateRespiration, ArtificialRetrospective StudiesAdrenal Cortex HormonesCOVID-19MortalityOxygen inhalation therapyRespiration, ArtificialSteroids

Identifiers

PMID37038264
PMCPMC10175872
OpenAlexW4363679293

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.