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Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19 by Luis Felipe Reyes; Alejandro Rodriguez; Alirio Bastidas; Daniela Parra-Tanoux; Yuli V. Fuentes; Esteban García-Gallo; Gerard Moreno; Gustavo Ospina-Tascon; Glenn Hernandez; Edwin Silva; Ana Maria Díaz; Manuel Jibaja; Magdalena Vera; Emilio Díaz; María Bodí; Jordi Solé-Violán; Ricard Ferrer; Antonio Albaya-Moreno; Lorenzo Socias; Ángel Estella; Ana Loza-Vazquez; Ruth Jorge-García; Isabel Sancho; Ignacio Martin-Loeches is a Medicine article available to read on EtoBox.

What is Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19 about?

Purpose: Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. Methods: This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation between dexamethasone treatment and ICU-RTI. Results: A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p < 0.

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Author

Luis Felipe Reyes; Alejandro Rodriguez; Alirio Bastidas; Daniela Parra-Tanoux; Yuli V. Fuentes; Esteban García-Gallo; Gerard Moreno; Gustavo Ospina-Tascon; Glenn Hernandez; Edwin Silva; Ana Maria Díaz; Manuel Jibaja; Magdalena Vera; Emilio Díaz; María Bodí; Jordi Solé-Violán; Ricard Ferrer; Antonio Albaya-Moreno; Lorenzo Socias; Ángel Estella; Ana Loza-Vazquez; Ruth Jorge-García; Isabel Sancho; Ignacio Martin-Loeches

Publisher

Elsevier BV

Published

2022

Language

EN

Field

Medicine (Health Sciences)