Effects of dexamethasone on immune dysfunction and ventilator-associated pneumonia in COVID-19 acute respiratory distress syndrome: an observational study.
Martin CourMarie SimonLaurent ArgaudGuillaume MonneretFabienne VenetPublished in: Journal of intensive care (2021)
Dexamethasone improves survival of patients with COVID-19 acute respiratory distress syndrome, but might shorten the delay between the start of invasive mechanical ventilation and the occurrence of ventilator-associated pneumonia, suggesting possible worsening of COVID-19-induced immune dysfunction with this treatment. In a prospective observational study, we found that mechanically ventilated patients with COVID-19 treated with dexamethasone presented earlier ventilator-associated pneumonia, had significantly lower monocyte Human Leukocyte Antigen-DR expression and number of circulating CD4 + cells after ICU admission, than those not treated with corticoids.
Keyphrases
- acute respiratory distress syndrome
- mechanical ventilation
- respiratory failure
- extracorporeal membrane oxygenation
- coronavirus disease
- sars cov
- endothelial cells
- high dose
- low dose
- high glucose
- induced apoptosis
- oxidative stress
- intensive care unit
- emergency department
- poor prognosis
- diabetic rats
- dendritic cells
- peripheral blood
- risk assessment
- respiratory syndrome coronavirus
- binding protein
- drug induced
- combination therapy
- induced pluripotent stem cells
- cell proliferation
- endoplasmic reticulum stress
- long non coding rna
- smoking cessation
- editorial comment
- replacement therapy