High dose dexamethasone treatment for Acute Respiratory Distress Syndrome secondary to COVID-19: a structured summary of a study protocol for a randomised controlled trial

Maskin, Luis Patricio; Olarte, Gabriel Leonardo; Pálizas, Fernando; Velo, Agostina E; Lurbet, María Fernanda; Bonelli, Ignacio; Baredes, Natalio; Rodríguez, Pablo

doi:10.1186/s13063-020-04646-y

Cited by 28 publications

(28 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, in the cases, the final diagnosis of COVID-19 was usually made by CT scan and not by RT-PCR testing. It has been suggested that only patients with a positive RT-PCR test should be included in clinical trials 16 . Conceivably, physicians may be less likely to prescribe the treatments used for COVID-19 to patients with negative RT-PCR results.…”

Section: Discussionmentioning

confidence: 99%

Predictors of negative first SARS-CoV-2 RT-PCR despite final diagnosis of COVID-19 and association with outcome

Lascarrou

Colin

Thuaut³

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Reverse transcriptase-polymerase chain reaction (RT-PCR) testing is an important tool for diagnosing coronavirus disease 2019 (COVID-19). However, performance concerns have emerged recently, notably regarding sensitivity. We hypothesized that the clinical, biological, and radiological characteristics of patients with a false-negative first RT-PCR test and a final diagnosis of COVID-19 might differ from those of patients with a positive first RT-PCR test. We conducted a multicenter matched case–control study in COVID-19 patients. Patients with a negative first RT-PCR test were matched to patients with a positive first RT-PCR test on age, sex, and initial admission unit (ward or intensive care). We included 80 cases and 80 controls between March 30, and June 22, 2020. Neither mortality at hospital discharge nor hospital stay length differed between the two groups (P = 0.80 and P = 0.54, respectively). By multivariate analysis, two factors were independently associated with a lower risk of a first false-negative test, namely, headache (adjusted OR [aOR], 0.07; 95% confidence interval [95% CI], 0.01–0.49]; P = 0.007) and fatigue/malaise (aOR, 0.16; 95% CI, 0.03–0.81; P = 0.027); two other factors were independently associated with a higher risk of a first false-negative test, namely, platelets > 207·103 mm−3 (aOR, 3.81; 95% CI, 1.10–13.16]; P = 0.034) and C-reactive protein > 79.8 mg·L−1 (aOR, 4.00; 95% CI, 1.21–13.19; P = 0.023). Patients with suspected COVID-19 whose laboratory tests indicating marked inflammation were at higher risk of a first false-negative RT-PCR test. Strategies involving serial RT-PCR testing must be rigorously evaluated.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of negative first SARS-CoV-2 RT-PCR despite final diagnosis of COVID-19 and association with outcome

Lascarrou

Colin

Thuaut³

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…When a patient is faced with a serious stress like COVID-19, it is difficult for doctors to avoid using glucocorticoids [16]. Therefore, doctors in various countries initiated a number of clinical trials to assess the efficacy of glucocorticoids [17][18][19][20][21][22][23]. On 23 January The results of clinical trials on the benefits of using glucocorticoids in the treatment of patients with COVID-19 were gradually published in mid-2020.…”

Section: Glucocorticoids and Covid-19 Therapymentioning

confidence: 99%

Glucocorticoids are double-edged sword in the treatment of COVID-19 and cancers

Yang¹,

Yu²

2021

Int. J. Biol. Sci.

View full text Add to dashboard Cite

Glucocorticoids are important steroid hormones. As an outstanding scientific discovery, the scientist who discovered glucocorticoids was awarded the Nobel Prize in Physiology and Medicine in 1950. Cortisone (hydrocortisone) is a natural glucocorticoid, which is secreted with circadian rhythm by the cortical cells of adrenal glands. Physiologically, about 10-20 mg of hydrocortisone are secreted each day for maintaining homeostasis. Since the biological half-life of natural glucocorticoid is short, scientists developed various synthetic glucocorticoids including prednisone, prednisolone, methylprednisolone, triamcinolone, dexamethasone, betamethasone, and so on. These synthetic glucocorticoids are generated by modifying some structures based on the cortisone backbone, leading to extension of their biological half-life with stronger activities. In the face of severe infection, allergy, shock, trauma, pain, and other stresses, the demand for glucocorticoids increases dramatically. It is critical to supplement extra glucocorticoids to protect the biological functions of vital organs. However, the amount and duration of glucocorticoid administration need to be carefully adjusted, because a series of side effects may occur after long-term or high-dose usage of glucocorticoids. This review article will discuss the application of glucocorticoids in the treatment of patients with severe or critical COVID-19 and solid tumors of advanced stage. The controversy of using glucocorticoid in medical community will also be discussed. This review article will help doctors and basic researchers better understand the practical application of glucocorticoids.

show abstract

“…Third, low rate of final diagnosis according to positive PCR test is also a concern. Some protocols advocated positive PCR test to include patients (17) and we can hypotheses than physician will be less prone to prescribe treatment to patients without positive PCR test. Global sensitivy of RT-PCR is describe as to 70% (18) but with major impact of duration between symptoms onset and day of RT-PCR testing: between 38% of false negative at day of symptoms onset to 20% at day 8 and then false negative rate which increase again (19).…”

Section: Discussionmentioning

confidence: 99%

Predictors of characteristics associated with negative first SARS-CoV-2 PCR testing despite final diagnosis of COVID-19, and association with treatment and outcomes. The COVID-19 RT-PCR Study

Lascarrou

Colin

Thuaut³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Reverse transcriptase-polymerase chain reaction (RT PCR) testing is an important tool for the diagnosis of coronavirus disease 2019 (COVID19). However, performance concerns have recently emerged, especially about its sensitivity.. We hypothesized that clinical, biological and radiological characteristics of patients with false negative first RT-PCR testing, despite final diagnosis of COVID19, might differ from patients with positive first RT PCR. Methods: Case / control, multicenter study in which COVID19 patients with negative first RT PCR testing were matched to patients with positive first RT PCR on age, gender and initial admission unit (ward or intensive care). Results: Between March 30, and June 22, 2020, 80 cases and 80 controls were included. Neither proportion of death at hospital discharge, nor duration of hospital length stay differed between case and control patients (P=0.80 and P=0.54, respectively). In multivariate analysis, headache (adjusted OR: 0.07 [0.01 ; 0.49]; P=0.007) and fatigue/malaise (aOR: 0.16 [0.03 ; 0.81]; P=0.027) were associated with lower risk of false negative, whereas platelets > 207.103.mm-3 (aOR: 3.81 [1.10 ; 13.16]; P=0.034) and CRP > 79.8 mg.L-1 (aOR: 4.00 [1.21 ; 13.19]; P=0.023) were associated with higher risk of false negative. Interpretation: Patients with suspected COVID19 and higher inflammatory biological signs expected higher risk of false negative RT PCR testing. Strategy of serial RT PCR testings must be rigorously evaluated before adoption by clinicians.

show abstract

High dose dexamethasone treatment for Acute Respiratory Distress Syndrome secondary to COVID-19: a structured summary of a study protocol for a randomised controlled trial

Cited by 28 publications

References 0 publications

Predictors of negative first SARS-CoV-2 RT-PCR despite final diagnosis of COVID-19 and association with outcome

Predictors of negative first SARS-CoV-2 RT-PCR despite final diagnosis of COVID-19 and association with outcome

Glucocorticoids are double-edged sword in the treatment of COVID-19 and cancers

Predictors of characteristics associated with negative first SARS-CoV-2 PCR testing despite final diagnosis of COVID-19, and association with treatment and outcomes. The COVID-19 RT-PCR Study

Contact Info

Product

Resources

About