The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study
Identifieur interne : 001075 ( Ncbi/Merge ); précédent : 001074; suivant : 001076The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study
Auteurs : Tung Wai Auyeung [République populaire de Chine] ; Jenny S. W. Lee [République populaire de Chine] ; Wing Kin Lai [République populaire de Chine] ; Chun Hung Choi [République populaire de Chine] ; Hoi Kan Lee [République populaire de Chine] ; Joo Shim Lee [République populaire de Chine] ; Po Chun Li [République populaire de Chine] ; Ka Ho Lok [République populaire de Chine] ; Yuk Yung Ng [République populaire de Chine] ; Wai Ming Wong [République populaire de Chine] ; Yiu Ming Yeung [République populaire de Chine]Source :
- The Journal of Infection [ 0163-4453 ] ; 2004.
Abstract
To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS).
A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes.
Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity.
Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.
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DOI: 10.1016/j.jinf.2004.09.008
PubMed: 16038758
PubMed Central: 7132384
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study</title><author><name sortKey="Auyeung, Tung Wai" sort="Auyeung, Tung Wai" uniqKey="Auyeung T" first="Tung Wai" last="Auyeung">Tung Wai Auyeung</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Jenny S W" sort="Lee, Jenny S W" uniqKey="Lee J" first="Jenny S. W." last="Lee">Jenny S. W. Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lai, Wing Kin" sort="Lai, Wing Kin" uniqKey="Lai W" first="Wing Kin" last="Lai">Wing Kin Lai</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Choi, Chun Hung" sort="Choi, Chun Hung" uniqKey="Choi C" first="Chun Hung" last="Choi">Chun Hung Choi</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Hoi Kan" sort="Lee, Hoi Kan" uniqKey="Lee H" first="Hoi Kan" last="Lee">Hoi Kan Lee</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Joo Shim" sort="Lee, Joo Shim" uniqKey="Lee J" first="Joo Shim" last="Lee">Joo Shim Lee</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Li, Po Chun" sort="Li, Po Chun" uniqKey="Li P" first="Po Chun" last="Li">Po Chun Li</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen 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Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Wong, Wai Ming" sort="Wong, Wai Ming" uniqKey="Wong W" first="Wai Ming" last="Wong">Wai Ming Wong</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Yeung, Yiu Ming" sort="Yeung, Yiu Ming" uniqKey="Yeung Y" first="Yiu Ming" last="Yeung">Yiu Ming Yeung</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">16038758</idno><idno type="pmc">7132384</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132384</idno><idno type="RBID">PMC:7132384</idno><idno type="doi">10.1016/j.jinf.2004.09.008</idno><date when="2004">2004</date><idno type="wicri:Area/Pmc/Corpus">001190</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001190</idno><idno type="wicri:Area/Pmc/Curation">001190</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001190</idno><idno type="wicri:Area/Pmc/Checkpoint">001429</idno><idno type="wicri:explorRef" 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W." last="Lee">Jenny S. W. Lee</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lai, Wing Kin" sort="Lai, Wing Kin" uniqKey="Lai W" first="Wing Kin" last="Lai">Wing Kin Lai</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Choi, Chun Hung" sort="Choi, Chun Hung" uniqKey="Choi C" first="Chun Hung" last="Choi">Chun Hung Choi</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Hoi Kan" sort="Lee, Hoi Kan" uniqKey="Lee H" first="Hoi Kan" last="Lee">Hoi Kan Lee</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Joo Shim" sort="Lee, Joo Shim" uniqKey="Lee J" first="Joo Shim" last="Lee">Joo Shim Lee</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Li, Po Chun" sort="Li, Po Chun" uniqKey="Li P" first="Po Chun" last="Li">Po Chun Li</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Lok, Ka Ho" sort="Lok, Ka Ho" uniqKey="Lok K" first="Ka Ho" last="Lok">Ka Ho Lok</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Ng, Yuk Yung" sort="Ng, Yuk Yung" uniqKey="Ng Y" first="Yuk Yung" last="Ng">Yuk Yung Ng</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Wong, Wai Ming" sort="Wong, Wai Ming" uniqKey="Wong W" first="Wai Ming" last="Wong">Wai Ming Wong</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Yeung, Yiu Ming" sort="Yeung, Yiu Ming" uniqKey="Yeung Y" first="Yiu Ming" last="Yeung">Yiu Ming Yeung</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Journal of Infection</title><idno type="ISSN">0163-4453</idno><idno type="eISSN">1532-2742</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS).</p></sec><sec><title>Methods</title><p>A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes.</p></sec><sec><title>Results</title><p>Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity.</p></sec><sec><title>Conclusion</title><p>Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lee, N" uniqKey="Lee N">N. Lee</name></author><author><name sortKey="Hui, D" uniqKey="Hui D">D. Hui</name></author><author><name sortKey="Wu, A" uniqKey="Wu A">A. Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wong, G W K" uniqKey="Wong G">G.W.K. Wong</name></author><author><name sortKey="Hui, D S C" uniqKey="Hui D">D.S.C. Hui</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tsui, P T" uniqKey="Tsui P">P.T. Tsui</name></author><author><name sortKey="Kwok, M L" uniqKey="Kwok M">M.L. Kwok</name></author><author><name sortKey="Yuen, H" uniqKey="Yuen H">H. Yuen</name></author><author><name sortKey="Lai, S T" uniqKey="Lai S">S.T. Lai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peiris, J S M" uniqKey="Peiris J">J.S.M. Peiris</name></author><author><name sortKey="Lai, S T" uniqKey="Lai S">S.T. Lai</name></author><author><name sortKey="Poon, L L M" uniqKey="Poon L">L.L.M. Poon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="So, L K" uniqKey="So L">L.K. So</name></author><author><name sortKey="Lau, A C" uniqKey="Lau A">A.C. Lau</name></author><author><name sortKey="Yam, L Y" uniqKey="Yam L">L.Y. Yam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sampathkumar, P" uniqKey="Sampathkumar P">P. Sampathkumar</name></author><author><name sortKey="Temesgen, Z" uniqKey="Temesgen Z">Z. Temesgen</name></author><author><name sortKey="Smith, T F" uniqKey="Smith T">T.F. Smith</name></author><author><name sortKey="Thompson, R L" uniqKey="Thompson R">R.L. Thompson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Avendano, M" uniqKey="Avendano M">M. Avendano</name></author><author><name sortKey="Derkach, P" uniqKey="Derkach P">P. Derkach</name></author><author><name sortKey="Swan, S" uniqKey="Swan S">S. Swan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Booth, C M" uniqKey="Booth C">C.M. Booth</name></author><author><name sortKey="Matukas, L M" uniqKey="Matukas L">L.M. Matukas</name></author><author><name sortKey="Tomlinson, G A" uniqKey="Tomlinson G">G.A. Tomlinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Choi, K W" uniqKey="Choi K">K.W. Choi</name></author><author><name sortKey="Chau, T N" uniqKey="Chau T">T.N. Chau</name></author><author><name sortKey="Tsang, O" uniqKey="Tsang O">O. Tsang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ho, J C" uniqKey="Ho J">J.C. Ho</name></author><author><name sortKey="Ooi, G C" uniqKey="Ooi G">G.C. Ooi</name></author><author><name sortKey="Mok, T Y" uniqKey="Mok T">T.Y. Mok</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect</journal-id><journal-id journal-id-type="iso-abbrev">J. Infect</journal-id><journal-title-group><journal-title>The Journal of Infection</journal-title></journal-title-group><issn pub-type="ppub">0163-4453</issn><issn pub-type="epub">1532-2742</issn><publisher><publisher-name>The British Infection Society. Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16038758</article-id><article-id pub-id-type="pmc">7132384</article-id><article-id pub-id-type="publisher-id">S0163-4453(04)00229-4</article-id><article-id pub-id-type="doi">10.1016/j.jinf.2004.09.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Auyeung</surname><given-names>Tung Wai</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jenny S.W.</given-names></name><email>jleesw_2000@yahoo.com</email><xref rid="aff1" ref-type="aff">a</xref><xref rid="cor1" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Lai</surname><given-names>Wing Kin</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Chun Hung</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Hoi Kan</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Joo Shim</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Po Chun</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Lok</surname><given-names>Ka Ho</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Ng</surname><given-names>Yuk Yung</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Wong</surname><given-names>Wai Ming</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Yeung</surname><given-names>Yiu Ming</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib></contrib-group><aff id="aff1"><label>a</label>Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, New Territories, Hong Kong, China</aff><aff id="aff2"><label>b</label>Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong, China</aff><author-notes><corresp id="cor1"><label>*</label>Corresponding author. Tel.: +852 7102 5901; fax: +852 2468 5800. <email>jleesw_2000@yahoo.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>5</day><month>11</month><year>2004</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>8</month><year>2005</year></pub-date><pub-date pub-type="epub"><day>5</day><month>11</month><year>2004</year></pub-date><volume>51</volume><issue>2</issue><fpage>98</fpage><lpage>102</lpage><history><date date-type="accepted"><day>22</day><month>9</month><year>2004</year></date></history><permissions><copyright-statement>Copyright © 2004 The British Infection Society. Published by Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2004</copyright-year><copyright-holder>The British Infection Society</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract><sec><title>Objective</title><p>To study the effect of corticosteroids in the treatment of severe acute respiratory syndrome (SARS).</p></sec><sec><title>Methods</title><p>A retrospective cohort of 78 consecutive adult SARS patients admitted to a regional hospital in Hong Kong between March and May 2003 was analysed to study the effectiveness of corticosteroid. They were categorized according to whether or not corticosteroid therapy was given, and compared in terms of demographic characteristics, comorbidities, peak lactate dehydrogenase (LDH) levels and clinical outcomes. Established adverse prognostic factors including old age, comorbidities and high LDH levels were used as covariates in multiple logistic regressions to adjust for their confounding effect on adverse outcomes.</p></sec><sec><title>Results</title><p>Among 78 patients, 66 patients (84.6%) received corticosteroid. The LDH level was similar in both groups. The corticosteroid group had more adverse outcomes (37.9% vs. 16.7%) despite younger age and less comorbidity. In multivariate analysis, corticosteroid treatment was associated with a 20.7-fold increase in risk of either ICU admission or mortality, independent of age and disease severity.</p></sec><sec><title>Conclusion</title><p>Despite more favourable baseline characteristics and similar peak LDH levels, SARS patients given corticosteroid had more adverse outcomes.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>SARS</kwd><kwd>Severe acute respiratory syndrome</kwd><kwd>Coronavirus</kwd><kwd>Corticosteroid</kwd><kwd>Outcome</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Auyeung, Tung Wai" sort="Auyeung, Tung Wai" uniqKey="Auyeung T" first="Tung Wai" last="Auyeung">Tung Wai Auyeung</name></noRegion><name sortKey="Choi, Chun Hung" sort="Choi, Chun Hung" uniqKey="Choi C" first="Chun Hung" last="Choi">Chun Hung Choi</name><name sortKey="Lai, Wing Kin" sort="Lai, Wing Kin" uniqKey="Lai W" first="Wing Kin" last="Lai">Wing Kin Lai</name><name sortKey="Lee, Hoi Kan" sort="Lee, Hoi Kan" uniqKey="Lee H" first="Hoi Kan" last="Lee">Hoi Kan Lee</name><name sortKey="Lee, Jenny S W" sort="Lee, Jenny S W" uniqKey="Lee J" first="Jenny S. W." last="Lee">Jenny S. W. Lee</name><name sortKey="Lee, Joo Shim" sort="Lee, Joo Shim" uniqKey="Lee J" first="Joo Shim" last="Lee">Joo Shim Lee</name><name sortKey="Li, Po Chun" sort="Li, Po Chun" uniqKey="Li P" first="Po Chun" last="Li">Po Chun Li</name><name sortKey="Lok, Ka Ho" sort="Lok, Ka Ho" uniqKey="Lok K" first="Ka Ho" last="Lok">Ka Ho Lok</name><name sortKey="Ng, Yuk Yung" sort="Ng, Yuk Yung" uniqKey="Ng Y" first="Yuk Yung" last="Ng">Yuk Yung Ng</name><name sortKey="Wong, Wai Ming" sort="Wong, Wai Ming" uniqKey="Wong W" first="Wai Ming" last="Wong">Wai Ming Wong</name><name sortKey="Yeung, Yiu Ming" sort="Yeung, Yiu Ming" uniqKey="Yeung Y" first="Yiu Ming" last="Yeung">Yiu Ming Yeung</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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