The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO 2 /FiO 2 ≤ 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or ≤ 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p < 0.001). Time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users (p = 0.985). According to multivariate analysis, SARS-CoV-2 clearance was associated with age ≤ 70 years, a shorter duration of symptoms at admission, a baseline PaO 2 /FiO 2 > 200 mmHg, and a lymphocyte count at admission > 1.0 × 10 9 /L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.
【저자키워드】 viral infection, Infectious diseases, Diseases, 【초록키워드】 Corticosteroid, COVID-19, Corticosteroids, Hospitalization, Italy, Steroids, Lymphocyte count, Nasopharyngeal swab, lymphocyte, nasopharyngeal swabs, early treatment, Patient, Older age, Retrospective analysis, Admission, Multivariate analysis, Analysis, severe disease, steroid, Factor, Primary outcome, hospitalized COVID-19 patients, multivariate, mmHg, San Raffaele Hospital, SARS-CoV-2 clearance, time, difference, Cox model, multivariable, evaluate, proportion, treated, determine, baseline, duration of symptom, PaO, use of corticosteroids, 【제목키워드】 Corticosteroid, clearance, corticosteroid treatment, patients with moderate,