Correspondence
Answer to the “Glucocorticoid therapy in patients with COVID-19 and concurrent heart failure” correspondence
Respuesta a la carta «Tratamiento con glucocorticoides en pacientes con COVID-19 e insuficiencia cardíaca concurrente»
A. Salinas-Botrána,
, L.M. Pérez-Belmonteb,
, M. Méndez-Bailóna, en representación del grupo SEMI-COVID-19 Network
Corresponding author
Corresponding author
a Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria delHospital ClínicoSan Carlos (IdISSC),Madrid, Spain
b Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), Málaga, Spain
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Salinas-Botrán, L.M. Pérez-Belmonte, M. Méndez-Bailón" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Salinas-Botrán" "email" => array:1 [ 0 => "asalinasbotran@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:4 [ "nombre" => "L.M." "apellidos" => "Pérez-Belmonte" "email" => array:1 [ 0 => "luismiguelpb1984@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "M." 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This can be explained by the effects of the mineralocorticoid and sodium and water retention, as the letter’s authors correctly indicate.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Unfortunately, we do not have specific data regarding the type of GC used; the only data recorded were whether they were used or not, the dose used, and the duration of treatment (SEMI-COVID-19 Registry).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, the following considerations should be noted:</p><p id="par0015" class="elsevierStylePara elsevierViewall">First, the most used GC during the first wave of the epidemic in Spain was methylprednisolone, as a recent article indicated.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Evidence on the reduction in mortality associated with the use of dexamethasone was not reported until later on<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and as such, it was used less in our country during the first wave.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Second, the initial multivariable analysis conducted in our study included patients’ baseline clinical variables at the time of admission and did not include variables regarding treatment administered. We are currently working on a larger, more focused database in order to discern the effect of treatment, including the use of GC (especially dexamethasone) on this profile of patient.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Lastly, and in contrast to the possible deleterious effect of GC in patients with HF, it should be noted that some recent works have demonstrated the utility of other drugs in patients with HF during hospitalization for COVID-19. Patients with HF who continued treatment with renin-angiotensin-aldosterone system inhibitors during hospitalization had lower in-hospital mortality rates than those who did not receive them or in whom they were suspended.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, according to our results, GC should be used with caution in patients with HF, weighing their risks and benefits. More prospective, controlled studies on the use of GC in patients with HF and COVID-19 are needed to confirm these results.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Salinas-Botrán A, Pérez-Belmonte LM, Méndez-Bailón M. Respuesta a la carta «Tratamiento con glucocorticoides en pacientes con COVID-19 e insuficiencia cardíaca concurrente». Rev Clín Esp. 2022;222:311–312.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Características clínicas y factores de riesgo de mortalidad al ingreso en pacientes con insuficiencia cardíaca hospitalizados por COVID-19 en España" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Salinas-Botrán" 1 => "J. Sanz-Cánovas" 2 => "J. Pérez-Somarriba" 3 => "L.M. Pérez-Belmonte" 4 => "L. Cobos-Palacios" 5 => "M. 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