Secondary infections in critically ill patients with COVID-19 receiving steroid therapy.
Secondary infections in critically ill patients with COVID-19 receiving steroid therapy.
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DOI：
10.1177/00368504231207209
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发表时间：
2023-10
期刊：
影响因子：
2.1
通讯作者：
Malhotra, Atul
中科院分区：
文献类型：
--
作者：
Pearce, Alex K.;Zawaydeh, Qais;Mcguire, W. Cameron;Husain, Abdurrahman;Ayoub, Claudia;Sweeney, Daniel A.;Cotton, Shannon A.;Malhotra, Atul
继发感染可能发生在初次感染的治疗期间或之后。糖皮质激素可能会降低重症 COVID-19 患者的死亡率；然而，继发感染的风险尚未得到很好的描述。我们的主要目标是调查接受糖皮质激素治疗的 COVID-19 危重患者继发感染的风险。我们检查了 2020 年 1 月至 7 日在两个学术医疗中心重症监护室接受治疗的 COVID-19 患者。其中包括一百七名患者。其中，31 名患者接受了类固醇治疗，76 名患者没有接受治疗。对更大的队列进行分析，然后对 22 名类固醇患者和 22 名非类固醇患者进行配对分析。接受类固醇治疗的患者中有 14 名（45.2%）出现继发感染，而未接受类固醇治疗的患者有 35 名（46.1%）出现继发感染（p = 0.968）。继发感染最常见于呼吸道。大肠杆菌和金黄色葡萄球菌是最常见的微生物。类固醇治疗组的死亡率为 16.1%，而对照组为 23.7%（p = 0.388）。在进行配对分析和多变量逻辑回归后，继发感染或死亡率与接受类固醇治疗之间没有显着差异。继发感染在 COVID-19 危重患者中很常见，但继发感染的发生率并未受到类固醇治疗的显着影响。
Secondary infections can occur during or after the treatment of an initial infection. Glucocorticoids may decrease mortality in patients with severe COVID-19; however, risk of secondary infection is not well described. Our primary objective was to investigate the risk of secondary infection among critically ill patients with COVID-19 treated with glucocorticoids. We examined patients with COVID-19 being treated in the intensive care unit at two academic medical centers from 1 to 7/2020. One hundred-seven patients were included. Of these, 31 received steroids and 76 patients did not. Analysis of the larger cohort was performed followed by a matched pairs analysis of 22 steroid and 22 non-steroid patients. Secondary infection was seen in 14 patients (45.2%) receiving steroids compared to 35(46.1%) not receiving steroids (p = 0.968). Secondary infections were most frequently encountered in the respiratory tract. Escherichia coli and Staphylococcus aureus were the most frequently identified organisms. Mortality was 16.1% in the steroid-treated group compared to 23.7% in the control group (p = 0.388). After performing matched pairs analysis and multivariable logistic regression there was no significant difference between secondary infection or mortality and steroid receipt. Secondary infections were common among critically ill patients with COVID-19, but the incidence of secondary infection was not significantly impacted by steroid treatment.
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影响因子：
28.3
作者：
通讯作者：
--
影响因子：
8.8
作者：
Vincent, JL;de Mendonca, A;Blecher, S
通讯作者：
Blecher, S
DOI：
10.1164/rccm.201101-0135oc
发表时间：
2011-05-01
影响因子：
24.7
作者：
Brun-Buisson, Christian;Richard, Jean-Christophe M.;Brochard, Laurent
通讯作者：
Brochard, Laurent
影响因子：
120.7
作者：
Sterne, Jonathan A. C.;Murthy, Srinivas;Marshall, John C.
通讯作者：
Marshall, John C.
DOI：
10.1016/j.crphar.2022.100086
发表时间：
2022
影响因子：
--
作者：
Basu D;Chavda VP;Mehta AA
通讯作者：
Mehta AA