RT Journal Article
T1 Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19.
A1 Reyes, Luis Felipe
A1 Rodriguez, Alejandro
A1 Bastidas, Alirio
A1 Parra-Tanoux, Daniela
A1 Fuentes, Yuli V
A1 García-Gallo, Esteban
A1 Moreno, Gerard
A1 Ospina-Tascon, Gustavo
A1 Hernandez, Glenn
A1 Silva, Edwin
A1 Díaz, Ana Maria
A1 Jibaja, Manuel
A1 Vera, Magdalena
A1 Díaz, Emilio
A1 Bodí, María
A1 Solé-Violán, Jordi
A1 Ferrer, Ricard
A1 Albaya-Moreno, Antonio
A1 Socias, Lorenzo
A1 Estella, Ángel
A1 Loza-Vazquez, Ana
A1 Jorge-García, Ruth
A1 Sancho, Isabel
A1 Martin-Loeches, Ignacio
A1 LIVEN-COVID-19 Investigators and COVID-19 SEMICYUC Study Group, 
K1 COVID-19
K1 Critical care
K1 Dexamethasone
K1 Pneumonia
K1 Severe COVID-19
AB Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. This was a multicenter, prospective cohort study; conducted in ten countries in Latin America and Europe. We included patients older than 18 with confirmed SARS-CoV-2 requiring ICU admission. A multivariate logistic regression and propensity score matching (PSM) analysis was conducted to determine the relation between dexamethasone treatment and ICU-RTI. A total of 3777 patients were included. 2065 (54.7%) were treated with dexamethasone within the first 24 h of admission. After performing the PSM, patients treated with dexamethasone showed significantly higher proportions of VAP (282/1652 [17.1%] Vs. 218/1652 [13.2%], p = 0.014). Also, dexamethasone treatment was identified as an adjusted risk factor of ICU-RTI in the multivariate logistic regression model (OR 1.64; 95%CI: 1.37-1.97; p  Patients treated with dexamethasone for severe COVID-19 had a higher risk of developing ICU-acquired respiratory tract infections after adjusting for days of invasive mechanical ventilation and ICU length of stay, suggesting a cautious use of this treatment.
YR 2022
FD 2022-02-23
LK http://hdl.handle.net/10668/22297
UL http://hdl.handle.net/10668/22297
LA en
DS RISalud
RD Apr 11, 2025