The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study

To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS). A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They we...

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Bibliographic Details
Published in:	The Journal of infection Vol. 51; no. 2; pp. 98 - 102
Main Authors:	Auyeung, Tung Wai, Lee, Jenny S.W., Lai, Wing Kin, Choi, Chun Hung, Lee, Hoi Kan, Lee, Joo Shim, Li, Po Chun, Lok, Ka Ho, Ng, Yuk Yung, Wong, Wai Ming, Yeung, Yiu Ming
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier Ltd 01-08-2005 Elsevier The British Infection Society. Published by Elsevier Ltd
Subjects:	Adolescent Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - adverse effects Adult Aged Aged, 80 and over Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Cohort Studies Coronavirus Corticosteroid Demography Drug Combinations Female Hong Kong - epidemiology Human viral diseases Humans Infectious diseases Male Medical sciences Middle Aged Multivariate Analysis Odds Ratio Outcome Pharmacology. Drug treatments Prognosis Retrospective Studies SARS SARS coronavirus Severe acute respiratory syndrome Severe Acute Respiratory Syndrome - drug therapy Severe Acute Respiratory Syndrome - epidemiology Severe Acute Respiratory Syndrome - mortality Treatment Outcome Viral diseases Viral diseases of the respiratory system and ent viral diseases Hong Kong Asia China China, People's Rep., Hong Kong Corticosteroid SARS Coronavirus Severe acute respiratory syndrome Outcome Infection Lung disease Prognosis Treatment Respiratory disease Viral disease Cohort study
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Summary:	To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS). A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes. Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity. Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0163-4453 1532-2742
DOI:	10.1016/j.jinf.2004.09.008