| Abstract | Ciljevi: Primarni cilj provedenog istraživanja bio je utvrditi učestalost primjene i vrstu kortikosteroidne terapije COVID-19 bolesnika hospitaliziranih u KBC-u Split. Sekundarni cilj bio je pokazati korelaciju primjene kortikosteroidne terapije s komorbiditetima, odabranim laboratorijskim nalazima i smrtnim ishodom.
Ispitanici i postupci: Retrospektivno istraživanje dio je multicentrične studije i provedeno je na kohorti od 282 bolesnika hospitaliziranih na Klinici za infektologiju u Splitu tijekom studenog i prosinca 2020. godine. Za svakog ispitanika pretraživano je 244 stavki iz otpusnih pisama, a u analizu su uključene varijable: dob i spol ispitanika, broj dana provedenih u bolničkom liječenju, podatci o prethodnom pobolijevanju, primijenjena kortikosteroidna terapija, dijagnosticirana pneumonija, vrijednost saturacije periferne krvi kisikom, vrijednosti sistoličkog i dijastoličkog arterijskog tlaka te laboratorijski nalazi: koncentracija ureje, kreatinina, ukupnog bilirubina, D-dimera te udjeli neutrofila i limfocita.
Rezultati: Podatci o primjeni kortikosteroidne terapije odnose se na sve ispitanike uključene u istraživanje. Većina je ispitanika bila liječena kortikosteroidima (N = 214 (80%)). Pneumonija je dijagnosticirana u većine ispitanika kojima je primijenjena kortikosteroidna terapija. Saturacija periferne krvi kisikom bila je značajno niža kod ispitanika koji su primali kortikosteroidnu terapiju te je bila jednoliko raspodijeljena među spolovima. Kortikosteroid izbora bio je deksametazon, primijenjen u 169 (60%) bolesnika. Drugi najčešće primijenjeni kortikosteroid bio je metilprednizolon, primijenjen u 53 (19%) bolesnika. Samo jedan bolesnik liječio se hidrokortizonom (0,4%). Višestruku kortikosteroidnu terapiju primalo je 9 bolesnika. Koncentracija ureje, kreatinina, ukupnog bilirubina te D-dimera nije se razlikovala među bolesnicima obzirom na primjenu kortikosteroidne terapije. Bolesnici na kortikosteroidnoj terapiji nisu imali više komorbiditeta u odnosu na bolesnike bez terapije.
Zaključci: Bolesnici na kortikosteroidnoj terapiji češće su imali više simptoma COVID-19 bolesti pri prijemu u bolnicu, češće su bolovali od pneumonije i imali hipoksemiju. Omjer neutrofila i limfocita bio je niži u ovih bolesnika. Unatoč tome što je arterijska hipertenzija bila učestali komorbiditet, arterijski tlak nije se razlikovao među bolesnicima koji uzimaju ili ne uzimaju kortikosteroidnu terapiju. Primjena kortikosteroidne terapije nije bila povezana s komorbiditetima niti sa smrtnim ishodom. |
| Abstract (english) | Objectives: The primary objective of the research was to determine the frequency of use and type of corticosteroid therapy for COVID-19 patients hospitalized at the University Hospital Center Split. The secondary objective was to determine the correlation of corticosteroid therapy with comorbidities, selected laboratory findings, and death. Subjects and procedures: This retrospective study is part of a multicenter study and was conducted on a cohort of 282 patients hospitalized at the Clinic for Infectious Diseases in Split during November and December 2020. For each subject, 244 items from the discharge letters were searched, and the variables included in the analysis were age and sex of the patient, number of days receiving treatment in the hospital, data on previous illness, receipt of corticosteroid therapy, diagnosed pneumonia. Additionally, measurements of peripheral blood oxygen saturation, systolic and diastolic arterial pressure, and laboratory findings, including the concentration of urea, creatinine, total bilirubin, D-dimer, and proportions of neutrophils and lymphocytes were assessed.
Results: Data on the use of corticosteroid therapy refer to all subjects included in the study. Most subjects were treated with corticosteroids (N = 214 [80%]). Pneumonia was diagnosed in the majority of subjects who received corticosteroid therapy. Peripheral blood oxygen saturation was significantly lower in subjects receiving corticosteroid therapy and was equally distributed between the sexes. The corticosteroid of choice was dexamethasone used by 169 (60%) patients. The second most frequently used corticosteroid was methylprednisolone used by 53 (19%) patients. Only one patient was treated with hydrocortisone (0.4%). 9 patients received multiple corticosteroid therapy. The concentration of urea, creatinine, total bilirubin, and D-dimer did not differ between patients regarding their use of corticosteroid therapy. Patients on corticosteroid therapy did not have more comorbidities compared to patients without therapy.
Conclusions: Patients on corticosteroid therapy more often had more symptoms of COVID-19 when admitted to the hospital, more often suffered from pneumonia, and had hypoxemia. The ratio of neutrophils to lymphocytes was lower in these patients. Although arterial hypertension was a frequent comorbidity, the arterial pressure did not differ between patients taking and not taking corticosteroid therapy. The use of corticosteroid therapy was not associated with comorbidities or death. |
