類固醇治療總天數與COVID-19個案住院癒後的關聯性

The Association between Total Number of Days of Systemic Corticosteroid Treatments and Outcomes of Hospitalized Patients with COVID-19

住院期間最合適的糖皮質激素使用天數仍不清楚。本研究旨在通過回顧性分析闡明糖皮質激素總給藥天數對患者預後的影響。本篇採用回歸分析，探討新冠肺炎患者院內死亡率與出院時仍需使用呼吸器的危險因素。Cox回歸模型和Kaplan-Meier生存曲線用於研究60天生存和28天呼吸器生存的危險因素。結果共有171名COVID-19患者被納入分析。多變量邏輯回歸分析表明，只有類固醇治療的總天數和丙氨酸轉氨酶濃度影響院內死亡率。此外，只有類固醇治療的總天數獨立影響呼吸器撤除。回歸模型中，入院後60天和入院後28天插管的死亡風險增加與類固醇治療總天數≥10天相關。結論是接受超過10天的類固醇治療並未顯示出對患者結局有任何益處，例如新冠肺炎患者院內死亡率與出院時仍需使用呼吸器比率。未來需要進一步研究比較類固醇治療的不同持續時間。

The most suitable duration of glucocorticoid administration during hospitalization remains unclear. This study aimed to clarify the effect of the duration of administered systemic glucocorticoids on patient outcomes through retrospective analysis. Logistic regression analysis was employed to investigate the risk factors influencing patient mortality and invasive mechanical ventilation without weaning. Cox-regression models and Kaplan-Meier survival curves were used to investigate the risk factors for 60-day survival and 28-day invasive mechanical ventilation-free survival.
A total of 171 patients diagnosed with COVID-19 were included in the analysis. The multivariate logistic regression analysis revealed that only the total number of days of steroid treatment and alanine transaminase levels independently influenced in-hospital mortality. In addition, only the total number of days of steroid treatment independently influenced mechanical ventilation without weaning. In the Cox regression model, the increased risk of mortality 60 days after admission and intubation 28 days after admission was associated with the total number of days of steroid treatment of≥10 days. In conclusion, receiving steroid treatment for more than 10 days did not demonstrate any benefits in patient outcomes, such as in-hospital mortality and failure to wean from invasive mechanical ventilation.