The Effect Of Corticosteroid Therapy on the Frequency of Secondary Bacterial Infections And Mortality in COVID-19 Patients in ICU

Abstract

Objectives:There are recommendations and studies for the corticosteroid treatment of cytokine storm and ARDS in COVID-19 disease. The aim is to evaluate the rates of secondary infections and mortality in COVID-19 patients receiving various doses of corticosteroid treatment in the ICU. Methods: In a retrospective approach, 621 patients were analyzed and recorded in terms of age, gender, duration of mechanical ventilation, length of stay in intensive care, CRP, procalcitonin, LDH, IL-6, lymphocyte, D-dimer, ferritin values and corticosteroid doses as well as blood, urine, and tracheal aspiration growths. The patients were examined in 6 groups those who never took corticosteroids and those who took Methylprednisolone (MP) in doses of 250 mg, >250 mg, 80 mg, 40 mg, and 6 mg dexamethasone. The data were evaluated to determine if there have been significant relationships between corticosteroid doses and the rates of secondary infection and mortality. Results: The mean hospital stay of the patients was 11.2 ± 7.71 days, and the mean of invasive mechanical ventilation was 7.5 days. There was no significant difference between patients who did not use corticosteroids and patients who received 40 mg MP for the length of hospital stay. The length of hospital stay was significantly longer in the corticosteroid groups (p<0.001). There was no significant difference between all the groups according to the frequency of secondary infection. Conclusion: It has been observed that using different corticosteroids in intensive care patients with COVID-19 does not increase the secondary infection rate. J Microbiol Infect Dis 2022; 12(4):8-16.

Keywords

• COVID-19 disease
• corticosteroids
• secondary infection
• cytokine storm