ArticleCureus2024
Timing of Dexamethasone Initiation and Its Impact on the Outcome of COVID-19 Patients.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
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Who cites it
1 citing paper in PubMed.
- Observational
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction COVID-19 emerged in Wuhan in December 2019 and was declared a pandemic in March 2020. Severe cases manifest with respiratory distress. Corticosteroids, initially debated, are now recommended for severe cases following the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial findings. The timing of administration impacts outcomes, with earlier use potentially improving mortality and ICU stays. Regional studies on timing in severe cases are lacking, warranting further investigation. Methodology This retrospective cohort study was conducted at the Medical Department of King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Data were extracted from the BestCare database using a customized data collection sheet. Data were cleaned in Excel (Microsoft Corporation, Redmond, WA) and analyzed in IBM SPSS (IBM Corp., Armonk, NY). Results Our study included 791 COVID-19 patients with 43.1% being female (n = 341) and 56.9% being male (n = 450). The mean age was 69.5 years (SD = 16.1). Regarding BMI, 52.4% (n = 414) were obese. Most admissions were from the emergency department (90.6%, n = 717). Dexamethasone was administered to 80.3% (n = 635) of patients, with 53.0% (n = 419) receiving it early. Patients receiving early dexamethasone had significantly higher discharge rates (p < 0.001). Mortality was higher among those receiving late dexamethasone initiation (52.6%, p = 0.256). Moreover, there was an 87.5% death rate for doses >6 mg (p < 0.001). Intravenous administration was associated with higher mortality (62.3%, p < 0.001). Males had a higher likelihood of discharge (OR = 1.426, p = 0.043). Age and ventilation needs were strong mortality predictors (OR = 1.040, p < 0.001 and OR = 17.620, p < 0.001, respectively). Higher BMI slightly reduced mortality risk (OR = 0.978, p = 0.049). Conclusion Our study highlights significant associations between dexamethasone timing, dosage, and route of administration with COVID-19 outcomes. Early dexamethasone use correlated with higher discharge rates, while late initiation and higher doses were linked to increased mortality. Age and ventilation needs were critical predictors, with BMI showing a nuanced effect on mortality risk.
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