We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App





Common Blood Test Can Identify Which Patients Can Benefit or Be Harmed by Steroid Use for COVID-19 Treatment

By HospiMedica International staff writers
Posted on 27 Jul 2020
Print article
Illustration
Illustration
A new study has answered several key questions regarding steroid use for COVID-19 patients such as which patients are most likely to benefit from steroid therapy and whether some of them could be harmed, as well as discovered that a common blood test can identify the best candidates for steroid treatment.

The study led by Albert Einstein College of Medicine (Bronx, NY, USA) and Montefiore Health System (Bronx, NY, USA) confirms the findings of a large scale British trial of steroid use for COVID-19 patients and also suggests other formulations of steroids substitute for the agent studied in the British trial. The UK RECOVERY trial, a prospective, randomized, open-label study of the steroid dexamethasone versus standard of care, involved more than 6,000 patients with COVID-19. Dexamethasone reduced deaths by about one-third in patients on ventilators and by about one-fifth among people who needed oxygen but were not on ventilators. However, the study left questions about the use of steroids for treating some patients.

In the Einstein-Montefiore study, the researchers compared outcomes for two groups selected from nearly 3,000 people hospitalized at Montefiore with a positive COVID-19 test. One group of 140 patients was treated with steroids within 48 hours of hospital admission; a control group of 1,666 similar patients did not receive steroid therapy. Most of the patients who received steroid therapy received prednisone. Some received dexamethasone and methylprednisolone. Nearly all patients initially had a blood test to measure levels of C-reactive protein (CRP), which the liver produces in response to inflammation. The higher the CRP level in the blood, the greater amount of inflammation. A normal CRP level reported in the study is below 0.8 milligrams per deciliter of blood.

“We found that in patients with high levels of inflammation, namely a CRP level greater than 20, steroids were associated with a 75% reduction in the risk of going on mechanical ventilation or dying,” said Marla Keller, M.D., vice chair for research in the department of medicine at Einstein and Montefiore and lead author of the study. “Critically, we also found that for patients with a lower level of inflammation-CRP levels less than 10-steroid use was associated with an almost 200% increased risk of going on mechanical ventilation or death.”

“Our study is consistent with the promising findings from Britain, but for the first time, we are able to demonstrate that people can see the same life-saving benefits with steroid formulations other than dexamethasone,” said Dr. Keller who is also professor of medicine and of obstetrics & gynecology and women’s health at Einstein and an infectious disease specialist at Montefiore.

“Our findings suggest that steroid therapy should be reserved for people with high inflammation, as indicated by markedly elevated CRP levels,” said William Southern, M.D., M.S., professor of medicine and chief of the division of hospital medicine at Einstein and Montefiore and the study’s senior author. “It’s a different story for people who do not have significant inflammation: For them, any benefit is outweighed by the risks from using steroids.”

Related Links:
Albert Einstein College of Medicine
Montefiore Health System


Gold Member
12-Channel ECG
CM1200B
Gold Member
Real-Time Diagnostics Onscreen Viewer
GEMweb Live
Silver Member
Wireless Mobile ECG Recorder
NR-1207-3/NR-1207-E
New
Heart-Lung Machine
HL 40

Print article

Channels

Critical Care

view channel
Image: The permeable wearable electronics developed for long-term biosignal monitoring (Photo courtesy of CityUHK)

Super Permeable Wearable Electronics Enable Long-Term Biosignal Monitoring

Wearable electronics have become integral to enhancing health and fitness by offering continuous tracking of physiological signals over extended periods. This monitoring is crucial for understanding an... Read more

Surgical Techniques

view channel
Image: NTT and Olympus have begun the world\'s first joint demonstration experiment of a cloud endoscopy system (Photo courtesy of Olympus)

Cloud Endoscopy System Enables Real-Time Image Processing on the Cloud

Endoscopes, which are flexible tubes inserted into the body's natural openings for internal examination and biopsy collection, are becoming increasingly vital in medical diagnostics. Their minimal invasiveness... Read more

Patient Care

view channel
Image: The newly-launched solution can transform operating room scheduling and boost utilization rates (Photo courtesy of Fujitsu)

Surgical Capacity Optimization Solution Helps Hospitals Boost OR Utilization

An innovative solution has the capability to transform surgical capacity utilization by targeting the root cause of surgical block time inefficiencies. Fujitsu Limited’s (Tokyo, Japan) Surgical Capacity... Read more

Health IT

view channel
Image: First ever institution-specific model provides significant performance advantage over current population-derived models (Photo courtesy of Mount Sinai)

Machine Learning Model Improves Mortality Risk Prediction for Cardiac Surgery Patients

Machine learning algorithms have been deployed to create predictive models in various medical fields, with some demonstrating improved outcomes compared to their standard-of-care counterparts.... Read more

Point of Care

view channel
Image: The PATHFAST hs-cTnI-II high-sensitivity troponin assay has been developed for the PATHFAST Biomarker Analyzer (Photo courtesy of Polymedco)

POC Myocardial Infarction Test Delivers Results in 17 Minutes

Chest pain is the second leading cause of emergency department (ED) visits by adults in the United States, generating over 7 million visits annually. In the event of a suspected heart attack, physicians... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.