← Back to cohort
Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19: a cohort study
Alfredo Gea, Ángel M. Candela-Toha, María L. Hernández-Sanz, Egoitz Arruti, Jesús Villar, Carlos Ferrando, Pedro Castro, Marina Vendrell, G. Sánchez‐Etayo, Amalia Alcón, Isabel Belda, Mercé Agustí, Albert Carramiñana, Isabel Gracia, Miriam Panzeri, Irene León, Jaume Balust, Ricard Navarro, M.J. Arguís, María José Carretero, Cristina Ibáñez, Juan Perdomo, Antonio Rezusta López, Manuel López-Baamonde, Tomás Cuñat, Marta Ubré, Antonio Ojeda, Andrea Calvo, Eva Rivas, Paola Hurtado, Roger Pujol, Nuria Hinarejos Martín, J. Tercero, Pepe Sanahuja, Marta Magaldi, Miquel Coca-Martínez, Elena del Río, Julia Martínez-Ocón, Paula Masgoret, Monserrat Tió, A. Caballero, Raquel Risco, R. Bergé, Lidia Díaz Gómez, Nicolás de Riva, Ana Ruiz, Sebastián Jaramillo, José M. Balibrea, Francisco B. de Lacy, Ana Otero, Ainitze Ibarzábal, Raquel Bravo, Anna Carreras-Castañer, Daniel Martín-Barreda, Alfonso Alías, Mariano Balaguer‐Castro, Jorge Aliaga, Alex Almuedo-Riera, Joan Ramón Alonso, Rut Andrea, Gerard Sergi Angelès, Marilyn Arias, Fátima Aziz, Joan R. Badia, Enric Barbeta, Toni Torres, Guillem Batiste, Pau Benet, X. Borrat, María Borrell, Ernest Bragulat, Inmaculada Carmona, Manuel Castellà, Joan Ceravalls, Óscar Comino, Claudia Cucciniello, Clàudia De Deray, O De Diego, Paula De la Matta, Marta Farrero, Javier Fernández, Sara Fernández, Anna Fernández, Miquel Ferrer, Ana Fervienza, María Tallo Forga, Daniel Forné, C Redondo Galán, Andrea Gómez, Eduard Guasch, Adriana Jacas, Beltrán Jiménez, Pere Leyes, Teresa López, José Antonio Martínez, Graciela Martínez‐Palli, Jordi Mercadal, Guido Muñoz, José Luís Bernal Muñoz, Josep M. Nicolás, Jose T. Ortiz‐Pérez, Anna Peiró, Manuel Avelino Pestano Pérez, Esteban Poch, M Pujol, Eduard Quintana, Bartomeu Ramis, Enric Reverter, Irene Rovira, Pablo Ruiz, Elena Sandoval, Stefan Schneider, Oriol Sibila, Carla Solé, Àlex Soriano, Dolors Soy, M. Suárez, Adrián Téllez, David Toapanta, Antoni Torres, Xavier Urra, César Aldecoa, Alicia Bordell, Silvia Martín, Judith Andrés, A. Martínez Ruiz, Iñaki Bilbao Villasante, F. Iturri Clavero, Covadonga Peralta Álvarez, Julia T. Herrera Díez, Andrea García Trancho, Iñaki Sainz Mandiola, Carmen Suárez, Angela Ruiz Bocos, Eneritz Urrutia Izagirre, Pablo Ortiz de Urbina Fernández, Naiara Apodaka López, Leire Prieto Molano, Eunate Ganuza Martínez, Iratxe Vallinas Hidalgo, Karmele de Orte Sancho, Celia González Paniagua, Gemma Ortiz Labrador, Mireia Pérez Larrañaga, Marta López Miguelez, Estíbaliz Bárcena Andrés, Erik Urutxurtu Laureano, María Jesús Maroño Boedo, Blanca Escontrela Rodríguez, Aitziber Ereñozaga Camiruaga, Deiene Lasuen Aguirre, Ainhoa Zabal Maeztu, Ane Guereca Gala, Iker Castelo Korro, Andrés Álvarez Campo, Alejandro Carcelen Viana, Alejandro Alberdi Enríquez, Xabier Ormazábal Rementeria, Rosa Gutiérrez Rico, Pablo Barbier Damborenea, Marta Guerenabarrena Momeñe, Borja Cuesta Ruiz, Alejandro López Rico, Ana Rojo Polo, Covadonga García Grijelmo, Mikel Celorrio Reta, Eneko Martín Arroyo, Leire Artaza Aparicio, Iñaki Ituarte Aspiazu, Ane Igeregi Basabe, Itxaso Merino Julian, I. Rico, Maria Paz Martínez, Ramón Adalia Bartolomé, Luigi Zattera, Irina Adalid Hernández, Leire Larrañaga Altuna, Aina Serrallonga Castells, Adriana Vílchez Garcia, María Angélica Rivera Núñez, Lorena Román, Isabel Delgado, Adela Benítez-Cano Martínez, Mireia Chanzá Albert, Juan Carlos Álvarez García, Luis Aguilera Cuchillo, Sandra Beltrán de Heredia, Jesús Carazo Cordobés, Carlos Alberto García Bernedo, Fernando Escolano Villén, Francisco Javier Redondo Calvo, Rubén Villazala González, Víctor Baladrón González, Patricia Faba, Omar Montenegro, Natalia Bejarano Ramírez, Sergio Marcos Contreras, Alejandro García Rodríguez, Saleta Rey Vázquez, Cristina García Pérez, E. Miguélez, Irene Pérez Blanco, David García Rivera, Ane Martín de la Fuente, Marta Pardo, Vanessa Rodríguez, U. Bengoetxea, F. Ramasco, Sheila Olga Santidrián Bernal, Alvar Santa Cruz Hernando, A. Planas Roca, Carlos Figueroa Yusta, Esther García Villabona, Carmen Vallejo Lantero, Eva Patiño Rodriguez, Alvaro Esquivel Toledo, David Arribas Méndez, Mar Orts Rodriguez, Rosa Méndez Hernández, Jesús Nieves Alonso, Inés Imaz Artazcoz, Sonia Expósito Carazo, Carlos Román Guerrero, Elena Rojo Rodríguez, Ricardo Moreno González, Julia Hernando Santos, Jara Torrente Pérez, Esperanza Mata Mena, Manuel Martı́nez, Enrique Alday Muñoz, Patricia Martín Serrano, Laura Cotter Muñoz, Amadea Mjertan, Diego Gutiérrez Martínez, Carmen Rodríguez García, Olaya Alonso Viejo, Juan Alvarez Pereira, Ana Carmona Bonet, Diana Parrado López, Eva de Dios Tomas, R. Martín Celemín, María Luisa Meilan Paz, Luis Quecedo Gutiérrez, Noemí Diaz Velasco, Gabriel Martin Hernández, Francisco Garcia del Corral, Gloria Hernandez Arias, David Cuesta, Ana Gómez Rice, Encarna Mateos Sevillano, Natalia Olmos Molpeceres, Beatriz Domínguez, Ana Vázquez Lima, A Candela, Ismael A. Acevedo Bambaren, Paloma Alonso Montoiro, Fernando Álvarez Utrera, Juan Avellanosa Esteruelas, Amal Azzam López, Alberto José Balvis Balvis, Tommaso Bardi, María Beltrán Martín, Jacobo Benatar Haserfaty, Alberto Berruezo Camacho, Laura Betolaza Weimer, María del Mar Carbonell Soto, Cristina Seral, Cristina Cerro Zaballos, Elizabeth Claros Llamas, Pilar Coleta Orduna, Ingrid P. Cortes Forero, Pascual Agustín Crespo Aliseda, María Angélica de Pablo Pajares, Yolanda Díez Remesal, Trinidad Dorado Díaz, Noemí Echevarría Blasco, María Elena Elías Martín, Javier Felices Triviño, Natalia Fernández López, Cristina Fernández Martín, Natalia Ferreiro Pozuelo, Luis Gajate Martín, Clara Gallego Santos, Diego Gil Mayo, María Gómez Rojo, Claudia González Cibrián, Elena Herrera López, Borja Hinojal Olmedillo, Berta Iglesias Gallego, Sassan Khonsari, María Nuria Mane Ruiz, María Manzanero Arroyo, Ana María Mariscal Ortega, Sara Martín Burcio, María del Carmen Martín González, Ascensión Martín Grande, Jose Juan Martín López, Cecilia Martín Rabes, Marcos Martínez Borja, Nilda Martínez Castro, Adolfo Martínez Pérez, Snejana Matcan, Cristina Medrano Viñas, Lisset Miguel Herrera, Adrián Mira Betancur, María Montiel Carbajo, Javier Moya Moradas, Lorena Muñoz Pérez, Mónica Núñez Murias, Eva Ordiales González, Óscar Ordoñez Recio, Miguel Ángel Palomero Rodríguez, Diego Parise Roux, Lucia Pereira Torres, David Pestaña Lagunas, Juana María Pinto Corraliza, Marian Prieto Rodrigo, Inmaculada Rodriguez Diaz-Regaño, David Rodriguez Esteban, Víctor Rojas Pernia, Álvaro Ruigómez Saiz, Bárbara Saavedra Villarino, Noemí Samaranch Palero, Gloria Santos Pérez, Jaume Serna Pérez, Ana Belén Serrano Romero, Jesús Tercero López, Carlos García, Marta de la Torre Concostrina, Eva María Ureta Mesa, Eva Velasco Olarte, Judith Villahoz Martínez, Raúl Villalaba Palacios, Gema Villanueva García, Cristina Vogel de Medeiros, Soraya Gholamian Ovejero, Marta Vicente Orgaz, Patricia Lloreda Herradon, Cristina Crespo Gómez, Tatiana Sarmiento-Trujillo, Noemí García Medina, Maria Martinez‐García, Carles Espinós Ramírez, Nabil Mouhaffel Rivero, José A. Gil, Sonsoles Martı́n, María Victoria Moral, Josefina Galán, Pilar Paniagua, Sergio Agudelo‐Pérez, Albert Bainac, Ana Arias, Elsa Ramil, Jorge Escudero, Pablo Monedero, Carmen Cara, Andrea Lara, Elena Mendez Martínez, Jorge Mendoza, Íñigo Rubio Baines, Carmen Sala Trull, Pablo Montero López, Alejandro Fernández‐Montero, Rocío Armero Ibáñez, Juan Vicente Llau Pitarch, Fernando Rauer Alcóver, Cristina Álvarez Herreros, Cyntia Sánchez Martín, Lucía López Ocáriz Olmos, Marta Navas Moruno, Fernando García Montoto, M. F. Mirón Rodriguez, Laura Fuentes Coco, Cristina Hernández Gamito, Antonio Barba Orejudo, Luis Gerardo Smith Vielma, Yasmina González Marín, Francisco de Borja Amador Penco, Marta Donoso Domínguez, Silvia Esquivel Ramírez, J Carbonell, Berta López, Sara Martínez‐Castro, Gerardo Aguilar, María Gestal, Pablo Casas, Angel Outeiro Rosato, Andrea Naveiro Pan, María Alonso Portela, Adrián García Romar, Eva Mosquera Rodríguez, Diego Ruanova Seijo, Pablo Rama Maceiras, Francisco Castro-Ceoane, Esther Moreno López, Sergio Gustavo Rodríguez Gil, Julia Guillén Antón, Patricia García-Consuegra Tirado, Aurora Callau Calvo, Laura Forés Lisbona, María Carbonell Romero, Belén Albericio Gil, Laura Pradal Jarne, María Soria Lozano, Diego Loscos López, Andrea Patiño Abarca, Javier Pérez-Asenjo, Ángel Díez-Domínguez, Ion Zubizarreta, Jon Ramos, Iosu Fernández, Emilio Maseda, Alejandro Suárez-de-la-Rica, Javier Veganzones, Itziar Insausti, Javier Sagra, Sofía Díaz Carrasco, Ana Montero Feijoo, Julio Yagüe, Ignacio Garutti, Javier Hortal, Patricia Piñeiro, Matilde Piñeiro, M. Zaballos, Jamil Cedeño, Pablo García-Olivares, Alberto Garriido, Jose Eugenioi Guerrero, Eva Bassas Parga, Carmen García, Elisenda Pujol Rosa, Ana Tejedor Navarro, Roser Font Gabernet, María José Bernat, Meritxell Serra Valls, Cristina Cobaleda Garcia-Bernalt, Jesus Fernanz Anton, Adriana Sierra, Lucia Gil Gomez, Olaia Güenaga Vaqueiro, Susana Hernandez Marin, Laura Pardo Pinzon, Sira Garcia Aranda, Carlos Briones Orejuela, Edgar Cortes Sánchez, Alejandro Romero Fernández, Esther San‐José, Patricia Iglesias Garsabal, Guillermo Isidro Lopez, Ana Vicol, Sara Espejo Malagon, María Sanabra Loewe, Laura Grau Torradeflo, Lourdes Blanco Alcaide, Gloria Sanclemente, Pere Serra Pujol, Gustavo Cuadros Mendoza, Miroslawa Konarska, Fedra Bachs Almenara, Agnieszka Golska, Aleix Carmona Blesa, Arantxa Mas Serra, Javier Ripollés‐Melchor, Ana Nieto Moreno, Káteri Chao Novo, Sandra Gadín López, Elena Nieto Moreno, Bérénice Gutiérrez Tonal, Elena Lucena de Pablo, Barbara Algar Yañez, Beatriz Vázquez Rivero, Beatriz Nozal Mateo, Marina de Retes, Norma Aracil Escoda, Cristina Gallardo Mayo, Rosa González, Alicia Ruiz Escobar, Maria Laura Pelegrina López, Marina Valenzuela Peña, David Stolle Dueñas, Ane Abad‐Motos, Alfredo Abad‐Gurumeta, Ana Tirado Errazquin, Elena Sáez Ruiz, N Pérez, Francisco de Borja Bau González, César Morcillo Serra, Jessica Souto Higueras, Rosario Vicente, Raquel Ferrandis, Azucena Pajares Moncho, Ignacio Moreno Puigdollers, Juan Pérez Artacho Cortés, Ana Moret Calvo, Ana Pi Peña, María Catalán Fernández, Pilar Díaz Parada, Raquel Rey Carlín, Sarra Barreiro Aragunde, María Isabel Forés Chiva, A. Javier Agulló, Antonio Pérez Ferrer, María Galiana, Antoni Margarit, Válerie Mourre del Rio, Eva Heras Muxella, Anna Vidal
Bibliographic record
VenueCritical Care · 2021
Typearticle
Languageen
FieldMedicine
TopicAdrenal Hormones and Disorders
Canadian institutionsSt. Michael's Hospital
Fundersnot available
KeywordsMedicineCoronavirus disease 2019 (COVID-19)Critically illCritical illness2019-20 coronavirus outbreakSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Cohort studyCohortIntensive care medicinePandemicEmergency medicineMEDLINEPediatricsInternal medicineVirologyOutbreakInfectious disease (medical specialty)Disease
Abstract
BACKGROUND: Critically ill patients with coronavirus disease 19 (COVID-19) have a high fatality rate likely due to a dysregulated immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose. METHODS: This is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from 12th March to 29th June 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the first 48 h of ICU admission) with those who did not receive early corticosteroids (delayed group) or any corticosteroids at all (never group). Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications. RESULTS: A total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n = 485) had lower ICU mortality (30.3% vs. never 36.6% and delayed 44.2%) and lower 7-day mortality (7.2% vs. never 15.2%) compared to non-early treated patients. They also had higher number of ventilator-free days, less length of ICU stay, and less secondary infections than delayed treated patients. There were no differences in medical complications between groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens. CONCLUSION: Early use of corticosteroids in critically ill patients with COVID-19 is associated with lower mortality than no or delayed use, and fewer complications than delayed use.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.006
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
Opus teacher head0.021
GPT teacher head0.316
Teacher spread0.296 · how far apart the two teachers sit on this one work
Validation status
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".
Quick stats
Citations94
Published2021
Admission routes1
Has abstractyes