Observational studyCritical care (London, England)2021
Real-world corticosteroid use in severe pneumonia: a propensity-score-matched study.
Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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.
Who cites it
14 citing papers in PubMed, 26 citations in OpenAlex.
- MiR-342-3p Attenuates Inflammation and Pyroptosis in Severe Community-Acquired Pneumonia by Targeting EP300.Biochemical genetics · 2026Article
- Host-directed immune therapies: a second front in the battle against sepsis.The Journal of clinical investigation · 2026Review
- Biomarker-guided use of corticosteroids in pneumonia.Pneumonia (Nathan Qld.) · 2026Review
- Bacterial co-detection is associated with higher multidrug-resistantJAC-antimicrobial resistance · 2026Article
- Evaluating the effectiveness and safety of Xiyanping injection for severe pneumonia: a target trial emulation protocol using real-world data.Frontiers in pharmacology · 2026Article
- Corticosteroids in bacterial severe community-acquired pneumonia: lessons from recent trials.Frontiers in medicine · 2025Article
- Machine learning-based prediction model for bronchoalveolar lavage efficacy in severe pneumonia.Frontiers in medicine · 2025Article
- Next-generation sequencing guides the treatment of severe community-acquired pneumonia with empiric antimicrobial therapy failure: A propensity-score-matched study.PLoS neglected tropical diseases · 2024Article
- The relationship between lactate dehydrogenase and Apolipoprotein A1 levels in patients with severe pneumonia.Journal of medical biochemistry · 2024Article
- Risk factors for mortality in intensive care unit patients with Stenotrophomonas maltophilia pneumonia in South Korea.Acute and critical care · 2023Article
- Severe community-acquired pneumonia.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- Host-targeted approaches to sepsis due to community-acquired pneumonia.EBioMedicine · 2022Article
- Is therapeutic drug monitoring really helpful for managing piperacillin/tazobactam therapy in critically ill patients?Intensive care medicine · 2022Article
- The effect of low-molecular-weight heparin combined with amikacin on the coagulation function and bacterial clearance in the treatment of patients with severe senile pneumonia.Pakistan journal of medical sciencesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide despite correct antibiotic use. Corticosteroids have long been evaluated as a treatment option, but heterogeneous effects on survival have precluded their widespread implementation. We aimed to evaluate whether corticosteroids might improve clinical outcomes in patients with severe CAP and high inflammatory responses. STUDY DESIGN AND
methodsWe analyzed two prospective observational cohorts of patients with CAP in Barcelona and Rome who were admitted to intensive care with a high inflammatory response. Propensity score (PS) matching was used to obtain balance among the baseline variables in both groups, and we excluded patients with viral pneumonia or who received hydrocortisone.
resultsOf the 610 patients admitted with severe CAP, 198 (32%) received corticosteroids and 387 had major criteria for severe CAP. All patients had a baseline serum C-reactive protein above 15 mg/dL. Patients who received corticosteroids were more commonly male, had more comorbidities (e.g., cancer or chronic obstructive pulmonary disease), and presented with significantly higher sequential organ failure assessment scores. Eighty-nine patients met major severity criteria (invasive mechanical ventilation and/or septic shock) and were matched per group. Twenty-eight-day mortality was lower among patients receiving corticosteroids (16 patients, 18%) than among those not receiving them (28 patients, 31%; p = 0.037). After PS matching, corticosteroid therapy reduced the 28-day mortality risk in patients who met major severity criteria (hazard ratio (HR) 0.53, 95% confidence interval (CI) 0.29-0.98) (p = 0.043). In patients who did not meet major severity criteria, no benefits were observed with corticosteroid use (HR 0.88 (95%CI 0.32-2.36).
conclusionsCorticosteroid treatment may be of benefit for patients with CAP who have septic shock and/or a high inflammatory response and requirement for invasive mechanical ventilation. Corticosteroids appear to have no impact on mortality when these features are not present.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.