American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2018
Multicenter StudyCorticosteroid Therapy for Critically Ill Patients with the Middle East Respiratory Syndrome.
Corticosteroid therapy is commonly used among critically ill patients with Middle East Respiratory Syndrome (MERS), but its impact on outcomes is uncertain. Analyses of observational studies often do not account for patients' clinical condition at the time of corticosteroid therapy initiation. ⋯ Corticosteroid therapy in patients with MERS was not associated with a difference in mortality after adjustment for time-varying confounders but was associated with delayed MERS coronavirus RNA clearance. These findings highlight the challenges and importance of adjusting for baseline and time-varying confounders when estimating clinical effects of treatments using observational studies.