ICU sedation, delirium & recovery
Clinical phenotyping uncovers heterogeneous associations between corticosteroid treatment and survival in critically ill COVID-19 patients
Authors' conclusion
Our multinational study identified three distinct clinical COVID-19 phenotypes, each exhibiting marked differences in demographic, clinical, and immunological features, and in the response to late and short-term corticosteroid treatment.
Study context
- Population
- Critically ill COVID-19 patients admitted to 82 Dutch intensive care unit (ICUs), February 2020 to February 20226,225 Spanish replication cohort
- Participants
- 13,279 patients
- Exposure
- Corticosteroid treatment vs none, across clinical phenotypes
- Outcome
- Association between corticosteroid treatment and 90-day mortality across phenotypes
- Follow-up
- 90 days
Methodological detailsconsensus k-means clustering, multinational, multicentre, external reproduction cohort, longitudinal immunological characterization
- Consensus k-means clustering
- Multinational
- Multicentre
- External reproduction cohort
- Longitudinal immunological characterization
Main finding
As reported in the abstract
90-day mortality with corticosteroid therapy, by phenotype (subgroup)
Hazard ratio (CI)P value
COVIDICU1
1.59(1.09–2.31)
P = 0.015COVIDICU2
1.79(1.42–2.26)
P < 0.001COVIDICU3
1.08(0.76–1.54)
P = 0.654Observational data: associations, not effects.
Further findings
90-day in-hospital mortality by phenotype
Inflammatory response
- Most pronounced inflammatory response in COVIDICU3
Original publication
Clinical phenotyping uncovers heterogeneous associations between corticosteroid treatment and survival in critically ill COVID-19 patients. Intensive Care Med. Published 26 August 2024. doi:10.
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