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Effect of Corticosteroid Therapy on COVID-19, Influenza Coinfection Evaluated

Viral coinfections may become more common as COVID-19 restrictions continue to relax.

As countries across the globe ease restrictions put in place to limit the spread of COVID-19, the coinfection with the SARS-CoV-2 and influenza viruses may become more common, according to research results1 presented at IDWeek 2022, held October 19 through 23 in Washington, D.C.

These patients, researchers noted, are “more likely to receive invasive mechanical ventilation and have higher odds of in-hospital mortality.”

Previous study results have indicated that dexamethasone can reduce the risk of 28-day mortality in patients hospitalized with COVID-19, and on June 16, 2020, clinical treatment guidelines for COVID-19 in patients requiring supplemental oxygen were updated to include corticosteroids. However, corticosteroid therapy in severe influenza may increase mortality, and currently, the effect of steroids in patients with COVID-19 and influenza coinfection is unknown.

Researchers evaluated data from adults with RT-PCR confirmed SARS-CoV-2 and influenzas coinfection requiring supplemental oxygen at hospital admission. Patients hospitalized before June 16, 2020, were delineated as the “early” group; patients hospitalized on or after that group were the “late” group.

The cohort included 171 patients with coinfection (early group n=123; late group n=48). Twenty-five and 40 patients in each group, respectively, received steroids. In the early group, the proportion of those admitted to critical care was slightly lower among patients who received steroid therapies; invasive mechanical ventilation rates were similar across groups, and mortality was slightly higher among those who received steroids.

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Within the late group, both critical care admission and invasive mechanical ventilation rates were higher in patients not treated with corticosteroids.

One study limitation noted by researchers was a lack of data indicating the start of steroid treatment, “making it impossible to draw conclusions on the causality of the need for [invasive mechanical ventilation] and treatment with steroids in this analysis.”

Further research, they concluded, “should focus on the effect of steroids in COIVD-19 and influenza coinfected patients.

Reference

  1. Swets MC, Russel C, Harrison E, et al. Corticosteroid treatment in influenza virus and SARS-CoV-2 co-infected patients. Presented at: IDWeek 2022; October 19-23, 2022; Washington, D.C. Poster 260.

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