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Impact on Glucocorticoids in COVID-19 Varies With CRP Levels

MONDAY, July 27, 2020 -- The impact of glucocorticoid treatment on patients with COVID-19 varies according to C-reactive protein (CRP) levels, according to a study published online July 22 in the Journal of Hospital Medicine.

Marla J. Keller, M.D., from Montefiore Medical Center and the Albert Einstein College of Medicine in Bronx, New York, and colleagues conducted an observational study involving 1,806 hospitalized COVID-19 patients; 140 were treated within 48 hours of admission with glucocorticoids.

The researchers observed no association between early use of glucocorticoids and mortality or mechanical ventilation. The risk for mortality or mechanical ventilation was significantly reduced in association with glucocorticoid treatment of patients with initial CRP ≥20 mg/dL (odds ratio, 0.23); the risk for mortality or mechanical ventilation was significantly increased in association with glucocorticoid treatment of patients with CRP <10 mg/dL (odds ratio, 2.64).

"Our findings suggest a role for CRP to identify patients who may benefit from glucocorticoid therapy, as well as those in whom it may be harmful," the authors write. "Additional studies to further elucidate the role of CRP in guiding glucocorticoid therapy and to predict clinical response are needed."

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