articleTop 1% cited

Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome

American Journal of Respiratory and Critical Care Medicine · 2017 · Vol. 197(6) · pp. 757–767

Yaseen M. Arabi✉(College of Intensive Care Medicine)Yasser Mandourah(Riyadh Armed Forces Hospital)Fahad Al-Hameed(King Saud bin Abdulaziz University for Health Sciences)Anees Sindi(King Abdulaziz University)Ghaleb A. Almekhlafi(Riyadh Armed Forces Hospital)Mohamed A. Hussein(Institute of Bioinformatics)Jesna Jose(Institute of Bioinformatics)Ruxandra Pinto(University of Toronto)Awad Al‐Omari(Alfaisal University)Ayman Kharaba(King Fahad Hospital Jeddah)Abdullah Almotairi(King Fahd Medical City)Kasim Al Khatib(Al Noor Hospitals)Basem Alraddadi(Alfaisal University)Sarah Shalhoub(King Fahd Armed Forces Hospital)Ahmed Abdulmomen(King Saud University)Ismael Qushmaq(King Faisal Specialist Hospital & Research Centre)Ahmed Mady(King Saud Medical City)Othman Solaiman(King Faisal Specialist Hospital & Research Centre)Abdulsalam M. Al‐Aithan(King Abdulaziz Hospital)Rajaa Al‐Raddadi(University of Jeddah)Ahmed Ragab(King Fahad Hospital Jeddah)Hanan H. Balkhy(King Abdulaziz Medical City)Abdulrahman Al Harthy(Tanta University Hospital)Ahmad Deeb(King Saud bin Abdulaziz University for Health Sciences)Hanan Al Mutairi(King Saud bin Abdulaziz University for Health Sciences)Abdulaziz Al‐Dawood(College of Intensive Care Medicine)Laura Merson(University of Oxford)Frederick G. Hayden(University of Oxford)Robert Fowler(University of Toronto)

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Abstract

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.

Sepsis Diagnosis and Treatment Respiratory Support and Mechanisms COVID-19 Clinical Research StudiesMedicineCorticosteroidOdds ratioHazard ratioConfoundingConfidence intervalInternal medicineMarginal structural modelMechanical ventilationMiddle East respiratory syndrome coronavirus

MeSH terms

Adrenal Cortex HormonesCritical CareFemaleHumansMaleMiddle AgedRetrospective StudiesSaudi ArabiaCohort StudiesCritical IllnessTreatment OutcomeCoronavirus Infections

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Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)