Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study

Matteo Pagnesi; Riccardo M Inciardi; Carlo M Lombardi; Piergiuseppe Agostoni; Pietro Ameri; Lucia Barbieri; Antonio Bellasi; Rita Camporotondo; Claudia Canale; Valentina Carubelli; Stefano Carugo; Francesco Catagnano; Laura A Dalla Vecchia; Gian Battista Danzi; Mattia Di Pasquale; Margherita Gaudenzi; Stefano Giovinazzo; Massimiliano Gnecchi; Marco Guazzi; Annamaria Iorio; Maria Teresa La Rovere; Sergio Leonardi; Gloria Maccagni; Massimo Mapelli; Davide Margonato; Marco Merlo; Luca Monzo; Andrea Mortara; Vincenzo Nuzzi; Massimo Piepoli; Italo Porto; Andrea Pozzi; Filippo Sarullo; Gianfranco Sinagra; Chiara Tedino; Daniela Tomasoni; Maurizio Volterrani; Gregorio Zaccone; Michele Senni; Marco Metra

doi:10.1016/j.ijid.2021.05.056

Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study

Matteo Pagnesi, Riccardo M Inciardi, Carlo M Lombardi, Piergiuseppe Agostoni, Pietro Ameri, Lucia Barbieri, Antonio Bellasi, Rita Camporotondo, Claudia Canale, Valentina Carubelli, Stefano Carugo, Francesco Catagnano, Laura A Dalla Vecchia, Gian Battista Danzi, Mattia Di Pasquale, Margherita Gaudenzi, Stefano Giovinazzo, Massimiliano Gnecchi, Marco Guazzi, Annamaria IorioMaria Teresa La Rovere, Sergio Leonardi, Gloria Maccagni, Massimo Mapelli, Davide Margonato, Marco Merlo, Luca Monzo, Andrea Mortara, Vincenzo Nuzzi, Massimo Piepoli, Italo Porto, Andrea Pozzi, Filippo Sarullo, Gianfranco Sinagra, Chiara Tedino, Daniela Tomasoni, Maurizio Volterrani, Gregorio Zaccone, Michele Senni, Marco Metra

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality.

METHODS: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality.

RESULTS: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26-0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L).

CONCLUSIONS: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.

Original language	English
Pages (from-to)	270-273
Number of pages	4
Journal	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
Volume	108
DOIs	https://doi.org/10.1016/j.ijid.2021.05.056
Publication status	Published - 2021

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Pagnesi, M., Inciardi, R. M., Lombardi, C. M., Agostoni, P., Ameri, P., Barbieri, L., Bellasi, A., Camporotondo, R., Canale, C., Carubelli, V., Carugo, S., Catagnano, F., Dalla Vecchia, L. A., Danzi, G. B., Di Pasquale, M., Gaudenzi, M., Giovinazzo, S., Gnecchi, M., Guazzi, M., ... Metra, M. (2021). Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 108, 270-273. https://doi.org/10.1016/j.ijid.2021.05.056

Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study. / Pagnesi, Matteo; Inciardi, Riccardo M; Lombardi, Carlo M et al.

In: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, Vol. 108, 2021, p. 270-273.

Research output: Contribution to journal › Article › peer-review

Pagnesi, M, Inciardi, RM, Lombardi, CM, Agostoni, P , Ameri, P, Barbieri, L, Bellasi, A, Camporotondo, R, Canale, C, Carubelli, V, Carugo, S, Catagnano, F, Dalla Vecchia, LA, Danzi, GB, Di Pasquale, M, Gaudenzi, M, Giovinazzo, S, Gnecchi, M , Guazzi, M, Iorio, A, La Rovere, MT , Leonardi, S, Maccagni, G, Mapelli, M, Margonato, D, Merlo, M, Monzo, L, Mortara, A, Nuzzi, V, Piepoli, M, Porto, I, Pozzi, A, Sarullo, F, Sinagra, G, Tedino, C, Tomasoni, D , Volterrani, M, Zaccone, G, Senni, M & Metra, M 2021, 'Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study', International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, vol. 108, pp. 270-273. https://doi.org/10.1016/j.ijid.2021.05.056

Pagnesi M, Inciardi RM, Lombardi CM, Agostoni P , Ameri P, Barbieri L et al. Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021;108:270-273. doi: 10.1016/j.ijid.2021.05.056

Pagnesi, Matteo ; Inciardi, Riccardo M ; Lombardi, Carlo M et al. / Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study. In: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021 ; Vol. 108. pp. 270-273.

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title = "Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study",

abstract = "BACKGROUND: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality.METHODS: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality.RESULTS: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26-0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L).CONCLUSIONS: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.",

author = "Matteo Pagnesi and Inciardi, {Riccardo M} and Lombardi, {Carlo M} and Piergiuseppe Agostoni and Pietro Ameri and Lucia Barbieri and Antonio Bellasi and Rita Camporotondo and Claudia Canale and Valentina Carubelli and Stefano Carugo and Francesco Catagnano and {Dalla Vecchia}, {Laura A} and Danzi, {Gian Battista} and {Di Pasquale}, Mattia and Margherita Gaudenzi and Stefano Giovinazzo and Massimiliano Gnecchi and Marco Guazzi and Annamaria Iorio and {La Rovere}, {Maria Teresa} and Sergio Leonardi and Gloria Maccagni and Massimo Mapelli and Davide Margonato and Marco Merlo and Luca Monzo and Andrea Mortara and Vincenzo Nuzzi and Massimo Piepoli and Italo Porto and Andrea Pozzi and Filippo Sarullo and Gianfranco Sinagra and Chiara Tedino and Daniela Tomasoni and Maurizio Volterrani and Gregorio Zaccone and Michele Senni and Marco Metra",

year = "2021",

doi = "10.1016/j.ijid.2021.05.056",

language = "English",

volume = "108",

pages = "270--273",

journal = "International Journal of Infectious Diseases",

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TY - JOUR

T1 - Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study

AU - Pagnesi, Matteo

AU - Inciardi, Riccardo M

AU - Lombardi, Carlo M

AU - Agostoni, Piergiuseppe

AU - Ameri, Pietro

AU - Barbieri, Lucia

AU - Bellasi, Antonio

AU - Camporotondo, Rita

AU - Canale, Claudia

AU - Carubelli, Valentina

AU - Carugo, Stefano

AU - Catagnano, Francesco

AU - Dalla Vecchia, Laura A

AU - Danzi, Gian Battista

AU - Di Pasquale, Mattia

AU - Gaudenzi, Margherita

AU - Giovinazzo, Stefano

AU - Gnecchi, Massimiliano

AU - Guazzi, Marco

AU - Iorio, Annamaria

AU - La Rovere, Maria Teresa

AU - Leonardi, Sergio

AU - Maccagni, Gloria

AU - Mapelli, Massimo

AU - Margonato, Davide

AU - Merlo, Marco

AU - Monzo, Luca

AU - Mortara, Andrea

AU - Nuzzi, Vincenzo

AU - Piepoli, Massimo

AU - Porto, Italo

AU - Pozzi, Andrea

AU - Sarullo, Filippo

AU - Sinagra, Gianfranco

AU - Tedino, Chiara

AU - Tomasoni, Daniela

AU - Volterrani, Maurizio

AU - Zaccone, Gregorio

AU - Senni, Michele

AU - Metra, Marco

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality.METHODS: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality.RESULTS: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26-0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L).CONCLUSIONS: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.

AB - BACKGROUND: Glucocorticoid therapy has emerged as an effective therapeutic option in hospitalized patients with coronavirus disease 2019 (COVID-19). This study aimed to focus on the impact of relevant clinical and laboratory factors on the protective effect of glucocorticoids on mortality.METHODS: A sub-analysis was performed of the multicenter Cardio-COVID-Italy registry, enrolling consecutive patients with COVID-19 admitted to 13 Italian cardiology units between 01 March 2020 and 09 April 2020. The primary endpoint was in-hospital mortality.RESULTS: A total of 706 COVID-19 patients were included (349 treated with glucocorticoids, 357 not treated with glucocorticoids). After adjustment for relevant covariates, use of glucocorticoids was associated with a lower risk of in-hospital mortality (adjusted HR 0.44; 95% CI 0.26-0.72; p = 0.001). A significant interaction was observed between the protective effect of glucocorticoids on mortality and PaO2/FiO2 ratio on admission (p = 0.042), oxygen saturation on admission (p = 0.017), and peak CRP (0.023). Such protective effects of glucocorticoids were mainly observed in patients with lower PaO2/FiO2 ratio (<300), lower oxygen saturation (<90%), and higher CRP (>100 mg/L).CONCLUSIONS: The protective effects of glucocorticoids on mortality in COVID-19 were more evident among patients with worse respiratory parameters and higher systemic inflammation.

U2 - 10.1016/j.ijid.2021.05.056

DO - 10.1016/j.ijid.2021.05.056

M3 - Article

C2 - 34052406

VL - 108

SP - 270

EP - 273

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

SN - 1201-9712

ER -

Determinants of the protective effect of glucocorticoids on mortality in hospitalized patients with COVID-19: Insights from the Cardio-COVID-Italy multicenter study

Abstract

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