ArticleAnnals of intensive care2020
Impact of corticosteroid treatment on clinical outcomes of influenza-associated ARDS: a nationwide multicenter study.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Efficacy of corticosteroids in patients with acute respiratory distress syndrome: a meta-analysis.Annals of medicine · 2024Pooled it
- Longer Prehospitalization and Preintubation Periods in Intubated Non-survivors and ECMO Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Pooled it
- Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- Severe Influenza-Related Outcomes in Patients with Inflammatory Bowel Disease on Immunosuppressive Therapy: A Propensity-Matched Cohort Analysis.Digestive diseases and sciences · 2026Article
- Article
- Time-varying associations between corticosteroid dose and hospital mortality in ARDS: a sliding-window analysis of MIMIC-IV.BMC pulmonary medicine · 2026Observational
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- A Comparative Study of Glucocorticoids Efficacy in Acute Respiratory Distress Syndrome.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Review
- Clinical practice guidelines for the treatment and prophylaxis of influenza in China (2025 edition).Infectious diseases & immunity · 2026Article
- Flawed design and selection bias in critical care randomized controlled trials (RCTs): the patient safety risk of the "RCT mimic".Patient safety in surgery · 2025Review
- Current corticosteroid therapeutic strategy for community-acquired pneumonia in adults: indications, dosage, and timing.Journal of intensive care · 2025Review
- Article
- Article
- ARDS Mortality Prediction Model Using Evolving Clinical Data and Chest Radiograph Analysis.Biomedicines · 2024Article
- Corticosteroid Dosing Level, Incidence and Profile of Bacterial Blood Stream Infections in Hospitalized COVID-19 Patients.Viruses · 2024Article
- Rosmarinic acid treatment protects against lethal H1N1 virus-mediated inflammation and lung injury by promoting activation of the h-PGDS-PGDChinese medicine · 2023Article
- Corticosteroid Uptake For COVID-19 after Publication of RECOVERY: A Difference in Difference Model.Annals of the American Thoracic Society · 2023Article
- Risk Factors for Influenza-Induced Exacerbations and Mortality in Non-Cystic Fibrosis Bronchiectasis.Viruses · 2023Article
Corrections and comments
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Authors and funding
18 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCorticosteroid treatment has been widely used in the treatment of septic shock, influenza, and ARDS, although some previous studies discourage its use in severe influenza patients. This multicenter retrospective cohort study conducted in the intensive care units (ICUs) of eight medical centers across Taiwan aims to determine the real-world status of corticosteroid treatment in patients with influenza-associated acute respiratory distress syndrome (ARDS) and its impact on clinical outcomes. Between October 2015 and March 2016, consecutive ICU patients with virology-proven influenza infections who fulfilled ARDS and received invasive mechanical ventilation were enrolled. The impact of early corticosteroid treatment (≥ 200 mg hydrocortisone equivalent dose within 3 days after ICU admission, determined by a sensitivity analysis) on hospital mortality (the primary outcome) was assessed by multivariable logistic regression analysis, and further confirmed in a propensity score-matched cohort.
resultsAmong the 241 patients with influenza-associated ARDS, 85 (35.3%) patients receiving early corticosteroid treatment had similar baseline characteristics, but a significantly higher hospital mortality rate than those without early corticosteroid treatment [43.5% (37/85) vs. 19.2% (30/156), p < 0.001]. Early corticosteroid treatment was independently associated with increased hospital mortality in overall patients [adjusted odds ratio (95% CI) = 5.02 (2.39-10.54), p < 0.001] and in all subgroups. Earlier treatment and higher dosing were associated with higher hospital mortality. Early corticosteroid treatment was associated with a significantly increased odds of subsequent bacteremia [adjusted odds ratio (95% CI) = 2.37 (1.01-5.56)]. The analyses using a propensity score-matched cohort showed consistent results.
conclusionsEarly corticosteroid treatment was associated with a significantly increased hospital mortality in adult patients with influenza-associated ARDS. Earlier treatment and higher dosing were associated with higher hospital mortality. Clinicians should be cautious while using corticosteroid treatment in this patient group.
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