Corticosteroid therapy in patients with primary viralpneumonia due to pandemic (H1N1) 2009influenza

摘要

Objective: During the first pandemic, some patients with pandemic (H1N1) 2009influenza were treated with corticosteroids. The objective of this study was to assesstheeffect on survival of corticosteroid therapy in patients with pandemic (H1N1) 2009 influenza. Methods: Prospective, observational, multicenter study performed in 148 ICU. Data were recorded in the GTEI/SEMICYUC registry. Adult patients with pandemic (H1N1) 2009 influenza confirmed by rt-PCR were included in the analysis. Database records specified corticosteroid type and reason for corticosteroid treatment. Results: 372 patients with the diagnosis of primary viral pneumonia and completed outcomes treated in an ICU were included in the database. Mechanical ventilation was used in 70.2% of the patients. 136 (36.6%) patients received corticosteroids after a diagnosis of primary viral pneumonia. Obesity (35.6% vs 47.8% p=0.021) and asthma (7.6% vs 15.4% p=0.018), were more frequent in the group treated with corticosteroids. A Cox regression analysis adjusted for severity and potential confounding factors found that the use of corticosteroid therapy was not significantly associated with mortality (HR=1.06, 95% CI 0.626-1.801; p=0.825). Conclusions: Corticosteroid therapy in a selected group of patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza does not improve survival.