Repositori URV

Identifier: imarina:9247852

Handle: https://hdl.handle.net/20.500.11797/imarina9247852

Authors:
Felipe Reyes, LuisRodriguez, AlejandroBastidas, AlirioParra-Tanoux, DanielaFuentes, Yuli, VGarcia-Gallo, EstebanMoreno, GerardOspina-Tascon, GustavoHernandez, GleenSilva, EdwinDiaz, Ana MariaJibaja, ManuelVera-Alarcon, MagdalenaDiaz, EmilioBodi, MariaSole-Violan, JordiFerrer, RicardAlbaya-Moreno, AntonioSocias, LorenzoEstella, AngelLoza-Vazquez, AnaJorge-Garcia, RuthSancho, IsabelMartin-Loeches, IgnacioLIVEN-COVID-19 InvestigatorsCOVID-19 SEMICYUC Study Grp

Abstract:
Purpose: Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, es-pecially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. Methods: This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation be-tween dexamethasone treatment and ICU-RTI. Results: A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p < 0.001).