title: Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza.
abstract: OBJECTIVE
  During the first pandemic, some patients with pandemic (H1N1) 2009 influenza were treated with corticosteroids. The objective of this study was to assess the effect on survival of corticosteroid therapy in patients with pandemic (H1N1) 2009 influenza.
  
  
  METHODS
  Prospective, observational, multicenter study performed in 148 ICU. Data were recorded in the GTEI/SEMICYUC registry. Adult patients with pandemic (H1N1) 2009 influenza confirmed by rt-PCR were included in the analysis. Database records specified corticosteroid type and reason for corticosteroid treatment.
  
  
  RESULTS
  372 patients with the diagnosis of primary viral pneumonia and completed outcomes treated in an ICU were included in the database. Mechanical ventilation was used in 70.2% of the patients. 136 (36.6%) patients received corticosteroids after a diagnosis of primary viral pneumonia. Obesity (35.6% vs 47.8% p = 0.021) and asthma (7.6% vs 15.4% p = 0.018), were more frequent in the group treated with corticosteroids. A Cox regression analysis adjusted for severity and potential confounding factors found that the use of corticosteroid therapy was not significantly associated with mortality (HR = 1.06, 95% CI 0.626-1.801; p = 0.825).
  
  
  CONCLUSIONS
  Corticosteroid therapy in a selected group of patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza does not improve survival.
authors.affiliation: Critical Care Department, Hospital Sant Joan Despí Moisès Broggi, Jacint Verdaguer, 90, 08970 Sant Joan Despí, Barcelona, CIBERES, IISPV, Spain. emilio.diaz.santos@gmail.com
authors.forename: Emili
authors.initials: E
authors.lastname: Diaz
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martin-Loeches
authors.forename: Laura
authors.initials: L
authors.lastname: Canadell
authors.forename: Loreto
authors.initials: L
authors.lastname: Vidaur
authors.forename: David
authors.initials: D
authors.lastname: Suarez
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Socias
authors.forename: Angel
authors.initials: A
authors.lastname: Estella
authors.forename: Bernardo
authors.initials: B
authors.lastname: Gil Rueda
authors.forename: José Eugenio
authors.initials: JE
authors.lastname: Guerrero
authors.forename: Montserrat
authors.initials: M
authors.lastname: Valverdú-Vidal
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Vergara
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: López-Pueyo
authors.forename: Mónica
authors.initials: M
authors.lastname: Magret
authors.forename: Teresa
authors.initials: T
authors.lastname: Recio
authors.forename: Diego
authors.initials: D
authors.lastname: López
authors.forename: Jordi
authors.initials: J
authors.lastname: Rello
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodriguez
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D011024:Pneumonia, Viral / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones