Effects of dexamethasone on immune dysfunction and ventilator-associated pneumonia in COVID-19 acute respiratory distress syndrome: an observational study
Martin Cour, Marie Simon, Laurent Argaud, Guillaume Monneret, Fabienne Venet
Abstract
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.
Topics & Concepts
Observational studyMedicinePneumoniaDexamethasoneCoronavirus disease 2019 (COVID-19)Acute respiratory distressARDSImmune systemRespiratory distressSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)2019-20 coronavirus outbreakIntensive care medicineImmunologyInternal medicineVirologyAnesthesiaLungDiseaseInfectious disease (medical specialty)OutbreakRespiratory Support and MechanismsNosocomial Infections in ICUIntensive Care Unit Cognitive Disorders