Research from Albert Einstein College of Medicine and Montefiore Builds on Large British Study
BRONX, N.Y., July 22, 2020 /PRNewswire/ -- A new study led by Albert Einstein College of Medicine and Montefiore Health System confirms the findings of the large scale British trial of steroid use for COVID-19 patients and advances the research by answering several key questions: Which patients are most likely to benefit from steroid therapy? Could some of them be harmed? Can other formulations of steroids substitute for the agent studied in the British trial? The research was published today in the Journal of Hospital Medicine.
The U.K. RECOVERY trial, a prospective, randomized, open-label study of the steroid dexamethasone versus standard of care, involved more than 6,000 patients with COVID-19. Dexamethasone reduced deaths by about one-third in patients on ventilators and by about one-fifth among people who needed oxygen but were not on ventilators. However, the study leaves questions about the use of steroids for treating some patients.
"Our study is consistent with the promising findings from Britain, but for the first time, we are able to demonstrate that people can see the same life-saving benefits with steroid formulations other than dexamethasone," said Marla Keller, M.D., vice chair for research in the department of medicine at Einstein and Montefiore and lead author of the study. "We also found that a common blood test may identify the best candidates for steroid treatment." Dr. Keller is also professor of medicine and of obstetrics & gynecology and women's health at Einstein and an infectious disease specialist at Montefiore.
Authors of the Einstein-Montefiore study compared outcomes for two groups selected from nearly 3,000 people hospitalized at Montefiore with a positive COVID-19 test. One group of 140 patients was treated with steroids within 48 hours of hospital admission; and a control group of 1,666 similar patients did not receive steroid therapy. Most of the patients who received steroid therapy received prednisone. Some received dexamethasone and methylprednisolone.
Nearly all patients initially had a blood test to measure levels of C-reactive protein (CRP), which the liver produces in response to inflammation. The higher the CRP level in the blood, the greater amount of inflammation. A normal CRP level reported in the study is below 0.8 milligrams per deciliter of blood.
"We found that in patients with high levels of inflammation, namely a CRP level greater than 20, steroids were associated with a 75% reduction in the risk of going on mechanical ventilation or dying," said Dr. Keller. "Critically, we also found that for patients with a lower level of inflammation CRP levels less than 10 steroid use was associated with an almost 200% increased risk of going on mechanical ventilation or death."
A large percent of the people who succumb to COVID-19 die from the body's intense inflammatory response, which can overwhelm and severely damage the lungs. "Our findings suggest that steroid therapy should be reserved for people with high inflammation, as indicated by markedly elevated CRP levels," said William Southern, M.D., M.S., professor of medicine and chief of the division of hospital medicine at Einstein and Montefiore and the study's senior author. "It's a different story for people who do not have significant inflammation: for them, any benefit is outweighed by the risks from using steroids."
Study co-author Shitij Arora, M.D., associate professor of medicine at Einstein and a hospitalist at Montefiore, noted that the Einstein-Montefiore study included approximately equal numbers of male and female patients. In addition, nearly 40% of patients studied were Black and 36% were Hispanic. "The demographic diversity of the patients in this study suggests that steroid therapy benefits hospitalized COVID-19 patients affected by significant inflammation regardless of their race or ethnicity," he said.
The title of this paper is "Effect of Systemic Glucocorticoids on Mortality or Mechanical Ventilation in Patients With COVID-19." Other Einstein and Montefiore authors were Jen-Ting Chen, M.D., M.S., Elizabeth Kitsis, M.D., M.B.E., Shivani Agarwal, M.D., M.P.H., Michael Ross, M.D., and Yaron Tomer, M.D.
About Albert Einstein College of MedicineAlbert Einstein College of Medicine is one of the nation's premier centers for research, medical education and clinical investigation. During the 2019-20 academic year, Einstein is home to 724 M.D. students, 158 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,800 full-time faculty members located on the main campus and at its clinical affiliates. In 2019, Einstein received more than $178 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit http://www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.
About Montefiore Health SystemMontefiore Health System is one of New York's premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 10 hospitals, including the Children's Hospital at Montefiore, Burke Rehabilitation Hospital and close to 200 outpatient care sites. The advanced clinical and translational research at its' medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its' preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information please visit http://www.montefiore.org. Follow us on Twitter and view us on Facebook and YouTube.
View original content to download multimedia:http://www.prnewswire.com/news-releases/common-blood-test-identifies-benefits-and-risks-of-steroid-treatment-in-covid-19-patients-301097815.html
SOURCE Albert Einstein College of Medicine
Go here to see the original:
Common Blood Test Identifies Benefits and Risks of Steroid Treatment in COVID-19 Patients - BioSpace
- "Shift Happens" [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Getting Started With Your Personal Statement [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- I started this blog 1 year ago. I'm ready to become a medical doctor. [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Poll Results: "What is your GPA?" [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Why Ross University School of Medicine? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Why Ross University? (Continued) [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Filling out applications with the last 4 years in mind. [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- "Active and Passive Euthanasia" [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- 300 Word Personal Statement - First Draft [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- 300 Word Personal Statement - 2nd Draft [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- "Where did you do EMT training at?" [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- "is this jonathan that went to brazil in the summer of 2006?" [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- First Application is Away - Ross University [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- AMCAS—The American Medical College Application Service [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The Student Doctor Network [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Crime Incident - Public Safety Announcement: STUDENTS [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- AMCAS Deadlines & Delays - Answered [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Headstart on Secondary Applications - The Student Doctor Network [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The Complete Medical School & Admissions Guide - Revisited [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Interview Status - Ross University [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Finished my first interview. [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- "You have a 95% chance of acceptance..." [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- "I was just wondering if I have to go to medical school i will have to start college allover again." [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Interview Feedback - Allopathic Medical Schools - Ross University School of Medicine (Dominica Caribbean) [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- ACCEPTED! [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Step 1 Revisited [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- A Few More Thoughts On Moving [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Update [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Closing In [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Internet/Computer Hell [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Back On The Net [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- 1 More Day [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Loan Deferment Blog [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Graduated! [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- What Happened? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Interesting Case [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- What Made Me Stupid? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Blah. [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Call [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Medicine in the Media [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Was Medical School Worth It? [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Off I Go... [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Is It Worth It, Part 2 [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Oriented [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- GLBT in Medical School [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- GLBT in Residency Applications [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- I Survived [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Reflections on the First Week [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- All Good Things Must End [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- The Lone Coyote is Back [Last Updated On: November 8th, 2009] [Originally Added On: November 8th, 2009]
- Pre-med student switches gears to teach in Chicago school - Chicago Tribune [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Old-school barbecue coming to spot near Fort Worth medical district - Fort Worth Star Telegram [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Nursing home drug use puts many at risk - Boston Globe [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Dr. Anita Figueredo, first female surgeon in San Diego, dies at 93 - Los Angeles Times [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Stimulus funds pay for monkey research in NC - MiamiHerald.com [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Medicine as an economic engine - Buffalo News [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- UM medical school feels the squeeze - MiamiHerald.com [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- HARVARD MEDICAL SCHOOL ADVISER Bell's palsy not as serious as it appears - Detroit Free Press [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Baylor medical school works to get back on track - Houston Chronicle [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- From community college to Amherst College and Yale Medical School - WalletPop (blog) [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- Man questions merit of coke monkey study - UPI.com [Last Updated On: March 8th, 2010] [Originally Added On: March 8th, 2010]
- School Board has questions it wants answered about onsite medical clinic - Terre Haute Tribune Star [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- Stimulus Funds Pay for Monkey Research - NewsMax.com [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- Babylon schools head: Teen's collapse unrelated to athletics - Newsday (subscription) [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- Cost Of Medical School Rises In Recession - NPR [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- Flu Shots in Children Help People of All Ages - New York Times [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- A prescription for improving science education - Scope (blog) [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- Live kidney donors do not die sooner: study - Reuters [Last Updated On: March 9th, 2010] [Originally Added On: March 9th, 2010]
- UW football player suspended after alleged assault - Seattle Post Intelligencer [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- More Comparative Studies Needed to Guide Physicians Study finds less than a ... - ModernMedicine [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Conservationists worry about Mo. med school plan - KOAM-TV [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Dr. William D. Lynn - Baltimore Sun [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Suspect in North Dallas shootings became reclusive after parents died, family says - Dallas Morning News [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Drinkers Gain Less Weight - Harvard Crimson [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Long-Term Health Risks Low for Kidney Donors - WebMD [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- School resource officer remains in critical condition - Middletown Journal [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- New Lucian Leape Institute Report Finds That U.S. Medical Schools Are Falling ... - PR Newswire (press release) [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Dual degrees program expands for Mayo Medical School students - Post-Bulletin [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Comparative Effectiveness Research is a Must - TopNews United States [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]
- Long Beach OKs medical pot ordinance - Contra Costa Times [Last Updated On: March 10th, 2010] [Originally Added On: March 10th, 2010]