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Effects of 12 mg vs...
Effects of 12 mg vs. 6 mg dexamethasone on thromboembolism and bleeding in patients with critical COVID-19-a post hoc analysis of the randomized, blinded COVID STEROID 2 trial
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- Jonmarker, Sandra (author)
- Karolinska Institutet
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- Alarcon, Felix (author)
- Soder Sjukhuset, Sweden
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- Litorell, Jacob (author)
- Soder Sjukhuset, Sweden
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- Granholm, Anders (author)
- Copenhagen Univ Hosp, Denmark; Collaborat Res Intens Care CRIC, Denmark
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- Alm, Eva Joelsson (author)
- Karolinska Institutet
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- Chew, Michelle (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
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- Russell, Lene (author)
- Copenhagen Univ Hosp, Denmark; Copenhagen Univ Hosp Gentofte, Denmark
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- Weihe, Sarah (author)
- Zealand Univ Hosp, Denmark
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- Madsen, Emilie Kabel (author)
- Aarhus Univ Hosp, Denmark
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- Meier, Nick (author)
- Copenhagen Univ Hosp, Denmark
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- Leistner, Jens Wolfgang (author)
- Copenhagen Univ Hosp, Denmark
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- Martensson, Johan (author)
- Karolinska Institutet
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- Hollenberg, Jacob (author)
- Karolinska Institutet
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- Perner, Anders (author)
- Copenhagen Univ Hosp, Denmark; Collaborat Res Intens Care CRIC, Denmark
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- Kjaer, Maj-Brit Norregaard (author)
- Copenhagen Univ Hosp, Denmark; Collaborat Res Intens Care CRIC, Denmark
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- Munch, Marie Warrer (author)
- Copenhagen Univ Hosp, Denmark; Collaborat Res Intens Care CRIC, Denmark
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- Dahlberg, Martin (author)
- Karolinska Inst, Sweden; Soder Sjukhuset, Sweden
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- Cronhjort, Maria (author)
- Karolinska Institutet
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- Wahlin, Rebecka Rubenson (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2023-03-02
- 2023
- English.
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In: Annals of Intensive Care. - : SPRINGER. - 2110-5820. ; 13:1
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
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- BackgroundThromboembolism is more common in patients with critical COVID-19 than in other critically ill patients, and inflammation has been proposed as a possible mechanism. The aim of this study was to investigate if 12 mg vs. 6 mg dexamethasone daily reduced the composite outcome of death or thromboembolism in patients with critical COVID-19.MethodsUsing additional data on thromboembolism and bleeding we did a post hoc analysis of Swedish and Danish intensive care unit patients enrolled in the blinded randomized COVID STEROID 2 trial comparing 12 mg vs. 6 mg dexamethasone daily for up to 10 days. The primary outcome was a composite outcome of death or thromboembolism during intensive care. Secondary outcomes were thromboembolism, major bleeding, and any bleeding during intensive care.ResultsWe included 357 patients. Whilst in intensive care, 53 patients (29%) in the 12 mg group and 53 patients (30%) in the 6 mg group met the primary outcome with an unadjusted absolute risk difference of - 0.5% (95% CI - 10 to 9.5%, p = 1.00) and an adjusted OR of 0.93 (CI 95% 0.58 to 1.49, p = 0.77). We found no firm evidence of differences in any of the secondary outcomes.ConclusionsAmong patients with critical COVID-19, 12 mg vs. 6 mg dexamethasone daily did not result in a statistically significant difference in the composite outcome of death or thromboembolism. However, uncertainty remains due to the limited number of patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- COVID-19; Glucocorticoids; Steroids; Intensive care; Thrombosis; Thromboembolism; Pulmonary embolism; Bleeding
Publication and Content Type
- ref (subject category)
- art (subject category)
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Jonmarker, Sandr ...
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Alarcon, Felix
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Litorell, Jacob
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Granholm, Anders
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Alm, Eva Joelsso ...
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Chew, Michelle
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Russell, Lene
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Weihe, Sarah
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Madsen, Emilie K ...
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Meier, Nick
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Leistner, Jens W ...
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Martensson, Joha ...
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Hollenberg, Jaco ...
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Perner, Anders
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Kjaer, Maj-Brit ...
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Munch, Marie War ...
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Dahlberg, Martin
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Cronhjort, Maria
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Wahlin, Rebecka ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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Annals of Intens ...
- By the university
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Linköping University
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Karolinska Institutet