/les-corticoides-efficaces-dans-les-cas-

  • Les #corticoïdes efficaces dans les cas graves de #Covid-19 selon une étude [de l’#OMS]
    https://www.ouest-france.fr/sante/virus/coronavirus/les-corticoides-efficaces-dans-les-cas-graves-de-covid-19-selon-une-etu

    L’analyse regroupe des essais distincts de faibles doses d’hydrocortisone, de dexaméthasone et de méthylprednisolone, trois molécules de la famille des glycocorticoïdes, chez des patients hospitalisés en soins intensifs. Le taux de survie avoisine 68 % après un traitement aux corticostéroïdes contre environ 60 % en l’absence de ces molécules, précisent les auteurs de l’analyse dans un communiqué.

    • 3 publications sur le sujet (corticoïdes dans le COVID-19) sont apparues en même temps que celle de l’OMS.

      Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial | JAMA | JAMA Network
      https://jamanetwork.com/journals/jama/fullarticle/2770278

      Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions.

      Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial | JAMA | JAMA Network
      https://jamanetwork.com/journals/jama/fullarticle/2770276

      Low-dose hydrocortisone did not significantly reduce treatment failure in patients with COVID-19–related acute respiratory failure; however, the study was stopped early and was therefore likely underpowered.

      Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial | JAMA | JAMA Network
      https://jamanetwork.com/journals/jama/fullarticle/2770277

      Conclusions and Relevance Among patients with COVID-19 and moderate or severe ARDS, use of intravenous dexamethasone plus standard care compared with standard care alone resulted in a statistically significant increase in the number of ventilator-free days (days alive and free of mechanical ventilation) over 28 days.