Outcomes of corticosteroid treatment in critical Ill adult patients with respiratory viruses-related community acquired pneumonia e a propensity-matched case control study

Abstract

Abstract Objectives: To assess the outcomes of corticosteroid treatment in critically ill patients with respiratory viruserelated community-acquired pneumonia (CAP). Materials/methods: Adult patients who were admitted to the intensive care unit and had a polymerase chain reactioneconfirmed diagnosis of respiratory viruserelated CAP were included. Patients with and without corticosteroid treatment during the hospital course were retrospectively compared using a propensity scoreematched caseecontrol analysis. Results: From January 2018 to December 2020, 194 adult patients were enrolled with 1:1 matching. The 14-day and 28-day mortality rates did not differ significantly between patients treated with and without corticosteroids (14-day mortality: 7% versus 14%, P Z 0.11; 28-day mortality: 15% versus 20%, P Z 0.35). However, multivariate analysis by using a Cox regression model revealed that corticosteroid treatment was an independent factor predicting decreased mortality (adjusted odds ratio, 0.46; 95% confidence interval, 0.22e0.97, P Z 0.04). Subgroup analysis revealed lower 14-day and 28-day mortality rates in patients younger than 70 years treated with corticosteroids than in those not treated with corticosteroids (14-day mortality: 6% versus 23%; P Z 0.01 and 28-day mortality: 12% versus 27%; P Z 0.04). Conclusions: Non-elderly patients with severe respiratory viruserelated CAP are more likely to benefit from corticosteroid treatment than elderly patients.