Dexamethasone in Hospitalized Patients with Covid-19
Dexamethasone in Hospitalized Patients with Covid-19
复制标题
DOI：
10.1056/nejmoa2021436
复制
发表时间：
2021-02-25
影响因子：
158.5
通讯作者：
Landray, Martin J.
中科院分区：
文献类型：
--
作者：
Horby, Peter;Lim, Wei Shen;Landray, Martin J.
背景2019年冠状病毒病(新冠肺炎)与弥漫性肺损伤相关。糖皮质激素可调节炎症介导的肺损伤，从而减少呼吸衰竭和死亡的进展。方法在这项对照、开放试验中，我们比较了服用新冠肺炎的患者的一系列可能的治疗方法，我们随机分配患者接受口服或静脉注射地塞米松(每天一次6毫克)，最长10天或仅接受常规护理。主要结果是28天的死亡率。在这里，我们报告这项评估的最终结果。结果共有2104名患者被分配接受地塞米松治疗，4321名患者接受常规护理。总体而言，地塞米松组482例(22.9%)和常规护理组1110例(25.7%)患者在随机分组后28天内死亡(年龄调整比率，0.83；95%可信区间[CI]，0.75~0.93；P
BACKGROUNDCoronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death.METHODSIn this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the final results of this assessment.RESULTSA total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P