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Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

tetano

Editor, Senior Moderator
Journal of Infection
In Press, Accepted Manuscript - Note to users
doi:10.1016/j.jinf.2011.12.010 | How to Cite or Link Using DOI
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Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

Emili Diaza, Corresponding Author Contact Information, E-mail The Corresponding Author, Ignacio Martin-Loechesb, Laura Canadellc, Loreto Vidaurd, David SuarezPhDe, Lorenzo Sociasf, Angel Estellag, B. Gil-Ruedah, Jos? Eugenio Guerreroi, Montserrat Valverd?-Vidalj, Juan Carlos Vergarak, Mar?a Jes?s L?pez-Pueyol, M?nica Magretm, Teresa Recion, Diego L?pezo, Jordi Rellop, Alejandro Rodriguezq
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a Critical Care Department, Hospital Sant Joan Desp? Mois?s Broggi, Jacint Verdaguer, 90, 08970 Sant Joan Desp?, Barcelona; CIBERES, IISPV∗
b Critical Care Department, Hospital de Sabadell, Parc Taul? 1, 08208 Sabadell, Barcelona
c Pharmacy Department, Hospital Universitari de Tarragona Joan XXIII, Dr. Mallafre Guasch 4, 43005, Tarragona
d Critical Care Department, Hospital Donostia, Dr. Beguiristain, 107, 20014, San Sebastian
e Epidemiology and Assessment Unit, Fundaci? Parc Tauli, Universitat Aut?noma de Barcelona, Parc Tauli 1, 08028, Sabadell
f Critical Care Department, Hospital Son Ll?tzer, Ctra. Manacor, KM 4, 07198, Sa Creu Vermella, Palma (Mallorca) (Illes Balears)
g Critical Care Department, Hospital SAS, Ctra. Madrid-C?diz, s/n, 11407, Jerez de la Frontera
h Critical Care Department, Hospital Morales Meseguer, Av. Marqu?s de los V?lez, s/n, 30008 Murcia
i Critical Care Department, Hospital Gregorio Mara??n, Dr. Esquerdo 46, 28007, Madrid
j Critical Care Department, Hospital Universitario Arnau de Vilanova, Av. Alcalde Rovira Roure 80, 25198, Lleida
k Critical Care Department, Hospital de Cruces, Pl. Cruces-Gurutzeta 12, 48903 Barakaldo, Bizkaia
l Critical Care Department, Complejo Asistencial Universitario de Burgos, Av. Cid Campeador 96, 09005, Burgos
m Critical Care Department, Hospital Universitari Sant Joan de Reus, Ronda Josep Laporte, s/n, 43206, Reus, Tarragona
n Critical Care Department, Hospital General San Pedro de Alc?ntara, Av. Pablo Naranjo Porras s/n, 10003 C?ceres
o Critical Care Department, Fundaci?n Jim?nez D?az, Av. Reyes Cat?licos 2, 28040, Madrid
p Critical Care Department, Hospital Universitari Vall d?Hebron, CIBER Enfermedades Respiratorias (CIBERES), Universitat Aut?noma de Barcelona, Pg. Vall d?Hebron 119-129, 08035, Barcelona
q Critical Care Department, Hospital Universitari de Tarragona Joan XXIII, Dr. Mallafre Guasch 4, 43005 Tarragona, IISPV, Universitat Rovira I Virgili., and H1N1 SEMICYUC-CIBERES-REIPI Working Group (GETGAG)

Received 6 August 2011; revised 20 November 2011; Accepted 19 December 2011. Available online 2 January 2012.
Summary
Objective

During the first pandemic, some patients with pandemic (H1N1) 2009 influenza were treated with corticosteroids. The objective of this study was to assess the effect on survival of corticosteroid therapy in patients with pandemic (H1N1) 2009 influenza.
Methods

Prospective, observational, multicenter study performed in 148 ICU. Data were recorded in the GTEI/SEMICYUC registry. Adult patients with pandemic (H1N1) 2009 influenza confirmed by rt-PCR were included in the analysis. Database records specified corticosteroid type and reason for corticosteroid treatment.
Results

372 patients with the diagnosis of primary viral pneumonia and completed outcomes treated in an ICU were included in the database. Mechanical ventilation was used in 70.2% of the patients. 136 (36.6%) patients received corticosteroids after a diagnosis of primary viral pneumonia. Obesity (35.6% vs 47.8% p= 0.021) and asthma (7.6% vs 15.4% p=0.018), were more frequent in the group treated with corticosteroids. A Cox regression analysis adjusted for severity and potential confounding factors found that the use of corticosteroid therapy was not significantly associated with mortality (HR=1.06, 95% CI 0.626-1.801; p=0.825).
Conclusions

Corticosteroid therapy in a selected group of patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza does not improve survival.

http://www.sciencedirect.com/science/article/pii/S0163445311006025
 
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