• Medicina clinica · Aug 2020

    Case Reports Observational Study

    Effectiveness of corticoid pulses in patients with cytokine storm syndrome induced by SARS-CoV-2 infection.

    • José Luis Callejas Rubio, Juan de Dios Luna Del Castillo, Javier de la Hera Fernández, Emilio Guirao Arrabal, Manuel Colmenero Ruiz, and Norberto Ortego Centeno.
    • Unidad de Enfermedades Sistémicas, Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España. Electronic address: jlcalleja@telefonica.net.
    • Med Clin (Barc). 2020 Aug 28; 155 (4): 159-161.

    IntroductionCytokine storm syndrome (CSS) is a serious complication of COVID-19 patients. Treatment is tocilizumab. The use of glucocorticoids (GC) is controversial. In other very similar CSS, such as macrophage activation syndrome (MAS) and hemophagocytic syndrome (HFS), the main treatment are corticosteroids. Our objective is to evaluate the efficacy of GC in the CSS by COVID-19.PatientsWe included 92 patients with CSS associated to COVID-19 who received GC, GC, and tocilizumab and only tocilizumab. We determine CSS markers. We evaluated mortality, intubation, and a combined variable.ResultsIn all cases the percentages of events were lower in the group of patients with GC was administered. The hazard ratio of the final variables with GC versus the group in which only tocilizumab was administered was lower as CGs were considered, with statistical significance for survival.DiscussionThe early use of GC pulses could control SLC, with a lower requirement to use tocilizumab and a decrease in events such as intubation and death.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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