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ABSTRACT: Background
Thromboembolism is more common in patients with critical COVID-19 than in other critically ill patients, and inflammation has been proposed as a possible mechanism. The aim of this study was to investigate if 12 mg vs. 6 mg dexamethasone daily reduced the composite outcome of death or thromboembolism in patients with critical COVID-19.Methods
Using additional data on thromboembolism and bleeding we did a post hoc analysis of Swedish and Danish intensive care unit patients enrolled in the blinded randomized COVID STEROID 2 trial comparing 12 mg vs. 6 mg dexamethasone daily for up to 10 days. The primary outcome was a composite outcome of death or thromboembolism during intensive care. Secondary outcomes were thromboembolism, major bleeding, and any bleeding during intensive care.Results
We included 357 patients. Whilst in intensive care, 53 patients (29%) in the 12 mg group and 53 patients (30%) in the 6 mg group met the primary outcome with an unadjusted absolute risk difference of - 0.5% (95% CI - 10 to 9.5%, p = 1.00) and an adjusted OR of 0.93 (CI 95% 0.58 to 1.49, p = 0.77). We found no firm evidence of differences in any of the secondary outcomes.Conclusions
Among patients with critical COVID-19, 12 mg vs. 6 mg dexamethasone daily did not result in a statistically significant difference in the composite outcome of death or thromboembolism. However, uncertainty remains due to the limited number of patients.
SUBMITTER: Jonmarker S
PROVIDER: S-EPMC9979892 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
Jonmarker Sandra S Alarcón Felix F Litorell Jacob J Granholm Anders A Alm Eva Joelsson EJ Chew Michelle M Russell Lene L Weihe Sarah S Madsen Emilie Kabel EK Meier Nick N Leistner Jens Wolfgang JW Mårtensson Johan J Hollenberg Jacob J Perner Anders A Kjær Maj-Brit Nørregaard MN Munch Marie Warrer MW Dahlberg Martin M Cronhjort Maria M Wahlin Rebecka Rubenson RR
Annals of intensive care 20230302 1
<h4>Background</h4>Thromboembolism is more common in patients with critical COVID-19 than in other critically ill patients, and inflammation has been proposed as a possible mechanism. The aim of this study was to investigate if 12 mg vs. 6 mg dexamethasone daily reduced the composite outcome of death or thromboembolism in patients with critical COVID-19.<h4>Methods</h4>Using additional data on thromboembolism and bleeding we did a post hoc analysis of Swedish and Danish intensive care unit patie ...[more]