Clinical Outcome of Patients with COVID-19 Pneumonia Treated with Corticosteroids and Colchicine in Colombia

DOI record: { "DOI": "10.21203/rs.3.rs-94922/v1", "URL": "http://dx.doi.org/10.21203/rs.3.rs-94922/v1", "abstract": "<jats:title>Abstract</jats:title>\n <jats:p><jats:bold>Background:</jats:bold> To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications.The Objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine.<jats:bold>Materials and Methods:<jats:italic> </jats:italic></jats:bold>A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The patient’s information was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association.<jats:bold>Results:<jats:italic> </jats:italic></jats:bold>All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure / inspired oxygen fraction (PaFi) less than 300. 240 (79.7%) of patients received corticosteroids, and 145 (48.2%) also received colchicine; of these, 14 (9.6%) died vs. 23 (14.7%) of those who did not receive it. Hospital mortality due to severe Covid-19 Pneumonia was 12.3% in three hospitals in Colombia.<jats:bold>Conclusions:<jats:italic> </jats:italic></jats:bold>Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.</jats:p>", "accepted": { "date-parts": [ [ 2020, 10, 19 ] ] }, "author": [ { "affiliation": [ { "name": "Clinica Medellin" } ], "family": "Pinzón", "given": "Miguel Alejandro", "sequence": "first" }, { "affiliation": [ { "name": "Universidad CES" } ], "family": "Arango", "given": "Doris Cardona", "sequence": "additional" }, { "affiliation": [ { "name": "Clínica Medellín" } ], "family": "Betancur", "given": "Juan Felipe", "sequence": "additional" }, { "affiliation": [ { "name": "Clinica Medellin" } ], "family": "Holguín", "given": "Héctor", "sequence": "additional" }, { "affiliation": [ { "name": "Universidad CES" } ], "family": "Arias", "given": "Carolina Arias", "sequence": "additional" }, { "affiliation": [ { "name": "Clínica Medellín" } ], "family": "Muñoz", "given": "Bernardo Javier", "sequence": "additional" }, { "affiliation": [ { "name": "Clinica Medellin" } ], "family": "Amarillo", "given": "Michael", "sequence": "additional" }, { "affiliation": [ { "name": "Clínica Medellín" } ], "family": "Llano", "given": "Juan Felipe", "sequence": "additional" }, { "affiliation": [ { "name": "Clinica Medellin" } ], "family": "Montoya", "given": "Pablo", "sequence": "additional" } ], "container-title": [], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2020, 10, 23 ] ], "date-time": "2020-10-23T14:02:27Z", "timestamp": 1603461747000 }, "deposited": { "date-parts": [ [ 2022, 7, 29 ] ], "date-time": "2022-07-29T00:00:29Z", "timestamp": 1659052829000 }, "group-title": "In Review", "indexed": { "date-parts": [ [ 2024, 3, 3 ] ], "date-time": "2024-03-03T14:27:54Z", "timestamp": 1709476074943 }, "institution": [ { "name": "Research Square" } ], "is-referenced-by-count": 7, "issued": { "date-parts": [ [ 2020, 10, 23 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "unspecified", "delay-in-days": 0, "start": { "date-parts": [ [ 2020, 10, 23 ] ], "date-time": "2020-10-23T00:00:00Z", "timestamp": 1603411200000 } } ], "link": [ { "URL": "https://www.researchsquare.com/article/rs-94922/v1", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.researchsquare.com/article/rs-94922/v1.html", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "8761", "original-title": [], "posted": { "date-parts": [ [ 2020, 10, 23 ] ] }, "prefix": "10.21203", "published": { "date-parts": [ [ 2020, 10, 23 ] ] }, "publisher": "Research Square Platform LLC", "reference-count": 0, "references-count": 0, "relation": { "is-preprint-of": [ { "asserted-by": "subject", "id": "10.1186/s12941-021-00460-9", "id-type": "doi" } ] }, "resource": { "primary": { "URL": "https://www.researchsquare.com/article/rs-94922/v1" } }, "score": 1, "short-title": [], "source": "Crossref", "subtitle": [], "subtype": "preprint", "title": "Clinical Outcome of Patients with COVID-19 Pneumonia Treated with Corticosteroids and Colchicine in Colombia", "type": "posted-content" }