Early Stage Combination Treatment with Methylprednisolone Pulse and Remdesivir for Severe COVID-19 Pneumonia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Procedures
2.5. Outcomes
2.6. Statistical Analysis
3. Results
3.1. Patients
3.2. Mortality
3.3. Admission to the ICU and IMV
3.4. Values of SaO2/FiO25 and SaO2/FiO210 in the Two Groups of Patients
3.5. Regression Analyses
- (a)
- Thirty-day mortality: The treatment typology was the significant predictor of mortality. This variable explained much of the variation in the dependent variable (F = 7.55, p < 0.001; R2 = 0.18; treatment: β = −0.31). The treatment typology significantly affected mortality in the sample;
- (b)
- ICU admission and NIV: The treatment typology explained much of the variation in the ICU admission variable (F = 4.25, p < 0.05; R2 = 0.11; treatment: β = −0.29, t = −3.06, p < 0.05). Treatment was also a significant predictor of the need for NIV (F = 5.66, p < 0.001; R2 = 0.48; β = −0.32);
- (c)
- SaO2/FiO25: Treatment and age were significant predictors of SaO/FiO25 (F = 5.51, p = 0.002; R2 = 0.14). The t-statistic and β values that allow us to determine the relative importance of each variable in the model showed that the treatment typology and age explained a large part of the variation in the dependent variable (treatment: β = 0.28, t = 3.04, p = 0.003; age: β = −0.34, t = −2.46, p = 0.01);
- (d)
- SaO2/FiO210: Age and treatment were significant predictors of SaO2/FiO210 (F = 10.75, p < 0.001; R2 = 0.24, treatment: β = 0.33, t = 3.83, p < 0.003; age: β = −0.40, t = −3.09, p = 0.003).
3.6. Safety
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Treatment | M | SD | t | |
---|---|---|---|---|
Age | R + SCT | 64.38 | 14.27 | 0.24 (p = 0.81) |
R + HDCPT | 63.75 | 12.41 | ||
Comorbidity (CSI) | R + SCT | 3.11 | 2.09 | −0.28 (p = 0.77) |
R + HDCPT | 3.22 | 1.86 | ||
SaAO2/FiO20 | R + SCT | 207.30 | 44.17 | 1.14 (p = 0.25) |
R + HDCPT | 197.35 | 43.31 |
Outcome | Treatment | n/Total n (%) | p-Value |
---|---|---|---|
ICU admission and invasive ventilation | R + SCT R + HDCPT | 14/47 (29.8%) 4/55 (7.3%) | 0.04 |
NIV | R + SCT R + HDCPT | 30/47 (63.8%) 17/55 (30.9%) | <0.001 |
SAO25 | F = 5.518, p = 0.002; R2 = 0.14 | ||
---|---|---|---|
Standard β | t | p | |
Treatment | 0.28 | 3.04 | 0.003 |
Age | −0.34 | −2.46 | 0.01 |
Number of comorbidities | 0.22 | 1.55 | 0.12 |
SAO210 | F = 10.75, p < 0.001; R2 = 0.24 | ||
Standard β | t | p | |
Treatment | 0.33 | 3.83 | < 0.001 |
Age | −0.40 | −3.09 | 0.003 |
Number of comorbidities | 0.07 | 0.58 | 0.56 |
NIV | F = 5.66, p < 0.001; R2 = 0.48 | ||
Standard β | t | p | |
Treatment | −0.32 | −3.45 | < 0.001 |
Age | 0.22 | 1.58 | 0.11 |
Number of comorbidities | −0.03 | −0.25 | 0.80 |
ICU Admission | F = 4.25, p < 0.05, R2 = 0.11 | ||
Standard β | t | p | |
Treatment | −0.29 | −3.06 | 0.003 |
Age | 0.14 | 0.99 | 0.32 |
Number of comorbidities | 0.03 | 0.23 | 0.82 |
EXITUS | F = 7.55, p < 0.001; R2 = 0.18 | ||
Standard β | t | p | |
Treatment | −0.31 | −3.41 | 0.001 |
Age | 0.23 | 1.73 | 0.08 |
Number of comorbidities | 0.07 | 0.53 | 0.59 |
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Mastruzzo, C.; Commodari, E.; Grasso, U.; La Rosa, V.L.; Balsamo, D.; Circo, C.; Oliveri, R. Early Stage Combination Treatment with Methylprednisolone Pulse and Remdesivir for Severe COVID-19 Pneumonia. Int. J. Environ. Res. Public Health 2023, 20, 1081. https://doi.org/10.3390/ijerph20021081
Mastruzzo C, Commodari E, Grasso U, La Rosa VL, Balsamo D, Circo C, Oliveri R. Early Stage Combination Treatment with Methylprednisolone Pulse and Remdesivir for Severe COVID-19 Pneumonia. International Journal of Environmental Research and Public Health. 2023; 20(2):1081. https://doi.org/10.3390/ijerph20021081
Chicago/Turabian StyleMastruzzo, Claudio, Elena Commodari, Umberto Grasso, Valentina Lucia La Rosa, Daniela Balsamo, Cristina Circo, and Rosario Oliveri. 2023. "Early Stage Combination Treatment with Methylprednisolone Pulse and Remdesivir for Severe COVID-19 Pneumonia" International Journal of Environmental Research and Public Health 20, no. 2: 1081. https://doi.org/10.3390/ijerph20021081