RESUMO
OBJECTIVES: The aim of this study was to evaluate the impact on 30-day mortality of early use of corticosteroids in COVID-19 patients with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. METHODS: All patients hospitalized with COVID-19 between April 15 and July 15, 2020, and requiring supplementary oxygen, were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticosteroids within the first 5 days of hospitalization and at least 24 hours prior to intubation were allocated to the 'early corticosteroids' group. To compare both populations and adjust for non-random treatment assignment bias, a weight-adjusted propensity score model was used. RESULTS: In total, 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. Analysis showed a reduction of 8.5% (p = 0.038) in 30-day mortality in the early corticosteroid group. The reduction in mortality was not significant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. CONCLUSION: Early corticosteroid use reduced mortality in patients with pneumonia due to COVID-19, who required supplementary oxygen but not initial invasive mechanical ventilation.
Assuntos
COVID-19 , Corticosteroides/uso terapêutico , Humanos , Pontuação de Propensão , Respiração Artificial , SARS-CoV-2 , EsteroidesRESUMO
Haematology, blood chemistry and urine values were determined for 44 adult free-ranging plains viscachas (Lagostomus maximus; Rodentia, Chinchillidae) in their pampas habitat in central Argentina. The study animals were captured in the wild and anaesthetized with a ketamine-xylazine combination for physical examination and sampling. Blood was obtained by venipuncture of the saphenous vein. Results for many of the blood parameters fall within the reference ranges for pet chinchillas. Differentiation of white blood cells revealed a predominantly neutrophil count for plains viscachas, while chinchillas have predominantly lymphocytes. Mean values for blood urea nitrogen, creatinine, aspartate aminotransferase and sodium were higher than the upper limit of the reference range for pet chinchillas. The results of seven analytes (haematocrit, haemoglobin, glucose, blood urea nitrogen, sodium, potassium, chloride) were compared by using both a portable blood analyser (i-STAT) in the field and conventional laboratory methods. In general, correlation and agreement between the two methods were low for most parameters.