Imperial College London
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Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Angus:2020:10.1001/jama.2020.17022,
author = {Angus, DC and Derde, L and Al-Beidh, F and Annane, D and Arabi, Y and Beane, A and van, Bentum-Puijk W and Berry, L and Bhimani, Z and Bonten, M and Bradbury, C and Brunkhorst, F and Buxton, M and Buzgau, A and Cheng, AC and de, Jong M and Detry, M and Estcourt, L and Fitzgerald, M and Goossens, H and Green, C and Haniffa, R and Higgins, AM and Horvat, C and Hullegie, SJ and Kruger, P and Lamontagne, F and Lawler, PR and Linstrum, K and Litton, E and Lorenzi, E and Marshall, J and McAuley, D and McGlothin, A and McGuinness, S and McVerry, B and Montgomery, S and Mouncey, P and Murthy, S and Nichol, A and Parke, R and Parker, J and Rowan, K and Sanil, A and Santos, M and Saunders, C and Seymour, C and Turner, A and van, de Veerdonk F and Venkatesh, B and Zarychanski, R and Berry, S and Lewis, RJ and McArthur, C and Webb, SA and Gordon, AC},
doi = {10.1001/jama.2020.17022},
journal = {JAMA},
pages = {1317--1329},
title = {Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19},
url = {http://dx.doi.org/10.1001/jama.2020.17022},
volume = {324},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance  Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.Objective  To determine whether hydrocortisone improves outcome for patients with severe COVID-19.Design, Setting, and Participants  An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020.Interventions  The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108).Main Outcomes and Measures  The primary end point was organ support–free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned –1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%).Results  After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137)
AU  - Angus,DC
AU  - Derde,L
AU  - Al-Beidh,F
AU  - Annane,D
AU  - Arabi,Y
AU  - Beane,A
AU  - van,Bentum-Puijk W
AU  - Berry,L
AU  - Bhimani,Z
AU  - Bonten,M
AU  - Bradbury,C
AU  - Brunkhorst,F
AU  - Buxton,M
AU  - Buzgau,A
AU  - Cheng,AC
AU  - de,Jong M
AU  - Detry,M
AU  - Estcourt,L
AU  - Fitzgerald,M
AU  - Goossens,H
AU  - Green,C
AU  - Haniffa,R
AU  - Higgins,AM
AU  - Horvat,C
AU  - Hullegie,SJ
AU  - Kruger,P
AU  - Lamontagne,F
AU  - Lawler,PR
AU  - Linstrum,K
AU  - Litton,E
AU  - Lorenzi,E
AU  - Marshall,J
AU  - McAuley,D
AU  - McGlothin,A
AU  - McGuinness,S
AU  - McVerry,B
AU  - Montgomery,S
AU  - Mouncey,P
AU  - Murthy,S
AU  - Nichol,A
AU  - Parke,R
AU  - Parker,J
AU  - Rowan,K
AU  - Sanil,A
AU  - Santos,M
AU  - Saunders,C
AU  - Seymour,C
AU  - Turner,A
AU  - van,de Veerdonk F
AU  - Venkatesh,B
AU  - Zarychanski,R
AU  - Berry,S
AU  - Lewis,RJ
AU  - McArthur,C
AU  - Webb,SA
AU  - Gordon,AC
DO  - 10.1001/jama.2020.17022
EP  - 1329
PY  - 2020///
SN  - 0098-7484
SP  - 1317
TI  - Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19
T2  - JAMA
UR  - http://dx.doi.org/10.1001/jama.2020.17022
UR  - https://jamanetwork.com/journals/jama/fullarticle/2770278
UR  - http://hdl.handle.net/10044/1/82224
VL  - 324
ER  -
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