tetano
Editor, Senior Moderator
Biomedicines
. 2023 Jan 9;11(1):164.
doi: 10.3390/biomedicines11010164.
Immuno-Modulatory Effects of Dexamethasone in Severe COVID-19-A Swedish Cohort Study
Sana Asif[SUP] 1 [/SUP], Robert Frithiof[SUP] 1 [/SUP], Anders Larsson[SUP] 2 [/SUP], Stephanie Franzén[SUP] 1 [/SUP], Sara Bülow Anderberg[SUP] 1 [/SUP], Bjarne Kristensen[SUP] 3 [/SUP], Michael Hultström[SUP] 1 4 [/SUP], Miklos Lipcsey[SUP] 1 5 [/SUP]
Affiliations
Abstract
Dexamethasone (Dex) has been shown to decrease mortality in severe coronavirus disease 2019 (COVID-19), but the mechanism is not fully elucidated. We aimed to investigate the physiological and immunological effects associated with Dex administration in patients admitted to intensive care with severe COVID-19. A total of 216 adult COVID-19 patients were included-102 (47%) received Dex, 6 mg/day for 10 days, and 114 (53%) did not. Standard laboratory parameters, plasma expression of cytokines, endothelial markers, immunoglobulin (Ig) IgA, IgM, and IgG against SARS-CoV-2 were analyzed post-admission to intensive care. Patients treated with Dex had higher blood glucose but lower blood lactate, plasma cortisol, IgA, IgM, IgG, D-dimer, cytokines, syndecan-1, and E-selectin and received less organ support than those who did not receive Dex (Without-Dex). There was an association between Dex treatment and IL-17A, macrophage inflammatory protein 1 alpha, syndecan-1 as well as E-selectin in predicting 30-day mortality. Among a subgroup of patients who received Dex early, within 14 days of COVID-19 debut, the adjusted mortality risk was 0.4 (95% CI 0.2-0.8), i.e., 40% compared with Without-Dex. Dex administration in a cohort of critically ill COVID-19 patients resulted in altered immunological and physiologic responses, some of which were associated with mortality.
Keywords: COVID-19; cytokines; dexamethasone; hypoxia; intensive care; treatment timing.
. 2023 Jan 9;11(1):164.
doi: 10.3390/biomedicines11010164.
Immuno-Modulatory Effects of Dexamethasone in Severe COVID-19-A Swedish Cohort Study
Sana Asif[SUP] 1 [/SUP], Robert Frithiof[SUP] 1 [/SUP], Anders Larsson[SUP] 2 [/SUP], Stephanie Franzén[SUP] 1 [/SUP], Sara Bülow Anderberg[SUP] 1 [/SUP], Bjarne Kristensen[SUP] 3 [/SUP], Michael Hultström[SUP] 1 4 [/SUP], Miklos Lipcsey[SUP] 1 5 [/SUP]
Affiliations
- PMID: 36672672
- PMCID: PMC9855905
- DOI: 10.3390/biomedicines11010164
Abstract
Dexamethasone (Dex) has been shown to decrease mortality in severe coronavirus disease 2019 (COVID-19), but the mechanism is not fully elucidated. We aimed to investigate the physiological and immunological effects associated with Dex administration in patients admitted to intensive care with severe COVID-19. A total of 216 adult COVID-19 patients were included-102 (47%) received Dex, 6 mg/day for 10 days, and 114 (53%) did not. Standard laboratory parameters, plasma expression of cytokines, endothelial markers, immunoglobulin (Ig) IgA, IgM, and IgG against SARS-CoV-2 were analyzed post-admission to intensive care. Patients treated with Dex had higher blood glucose but lower blood lactate, plasma cortisol, IgA, IgM, IgG, D-dimer, cytokines, syndecan-1, and E-selectin and received less organ support than those who did not receive Dex (Without-Dex). There was an association between Dex treatment and IL-17A, macrophage inflammatory protein 1 alpha, syndecan-1 as well as E-selectin in predicting 30-day mortality. Among a subgroup of patients who received Dex early, within 14 days of COVID-19 debut, the adjusted mortality risk was 0.4 (95% CI 0.2-0.8), i.e., 40% compared with Without-Dex. Dex administration in a cohort of critically ill COVID-19 patients resulted in altered immunological and physiologic responses, some of which were associated with mortality.
Keywords: COVID-19; cytokines; dexamethasone; hypoxia; intensive care; treatment timing.