Evidence map›Paper›PMID 34247526›Full record

ArticleJournal of intensive care medicine2021

The Impact of Corticosteroids on Secondary Infection and Mortality in Critically Ill COVID-19 Patients.

Lindsay A Ritter, Noel Britton, Emily L Heil, William A Teeter, Sarah B Murthi, Jonathan H Chow, Emily Ricotta, Daniel S Chertow, Alison Grazioli, Andrea R Levine

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Lindsay A RitterDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Noel BrittonDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Emily L HeilDepartment of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA.
William A TeeterDepartment of Emergency Medicine, Program in Trauma/Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Sarah B MurthiDepartment of Surgery, Program in Trauma/Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Jonathan H ChowDepartment of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine, Washington DC, USA.ORCID https://orcid.org/0000-0003-1750-3416
Emily RicottaNational Institute of Allergy and Infectious Diseases Division of Intramural Research, Epidemiology Unit, National Institutes of Health, Bethesda, MD, USA.
Daniel S ChertowCritical Care Medicine Department, National Institutes of Health Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
Alison GrazioliNational Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Andrea R LevineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.ORCID https://orcid.org/0000-0003-4103-1025
University of Maryland, Baltimore · USGeorge Washington University · USJohns Hopkins University · USNational Institute of Allergy and Infectious Diseases · USNational Institutes of Health · US

Funding

Clinical and Molecular Features of Coronavirus Disease 2019ZIACL090070 · CLC · CLINICAL CENTER · PI CHERTOW, DANIEL S · 2020 to 2025
$0k
6 · The paper itself

Abstract

backgroundCorticosteroids are part of the treatment guidelines for COVID-19 and have been shown to improve mortality. However, the impact corticosteroids have on the development of secondary infection in COVID-19 is unknown. We sought to define the rate of secondary infection in critically ill patients with COVID-19 and determine the effect of corticosteroid use on mortality in critically ill patients with COVID-19. STUDY DESIGN AND

methodsOne hundred and thirty-five critically ill patients with COVID-19 admitted to the Intensive Care Unit (ICU) at the University of Maryland Medical Center were included in this single-center retrospective analysis. Demographics, symptoms, culture data, use of COVID-19 directed therapies, and outcomes were abstracted from the medical record. The primary outcomes were secondary infection and mortality. Proportional hazards models were used to determine the time to secondary infection and the time to death.

resultsThe proportion of patients with secondary infection was 63%. The likelihood of developing secondary infection was not significantly impacted by the administration of corticosteroids (HR 1.45, CI 0.75-2.82,

conclusionCorticosteroids are an important and lifesaving pharmacotherapeutic option in critically ill patients with COVID-19, which have no impact on the likelihood of developing secondary infections.

Indexed as

CoinfectionCOVID-19Adrenal Cortex HormonesCritical IllnessHumansIntensive Care UnitsRetrospective StudiesSARS-CoV-2Adrenal Cortex HormonesCOVID-19ICUmortalitySARS-CoV-2secondary infectionsteroids

Identifiers

PMID34247526
PMCPMC8442131
OpenAlexW3177906579

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.