Association between adjunctive corticosteroid therapy and clinical outcomes in children with severe viral community-acquired pneumonia: A retrospective cohort study
Abstract
The therapeutic role of corticosteroids (CS) in severe community-acquired pneumonia (CAP) remains contentious, particularly in pediatric populations with viral etiology. Limited pediatric-specific evidence exists regarding CS efficacy in viral CAP, despite widespread clinical utilization. This retrospective cohort analysis examined the association between adjunctive CS therapy and clinical outcomes in children with severe viral CAP. A retrospective cohort analysis was conducted at a tertiary pediatric intensive care unit from January 2016 to December 2019. Inclusion criteria comprised positive viral pathogen detection following the 2011 Pediatric Infectious Diseases Society/Infectious Diseases Society of America severity criteria. The primary outcome was in-hospital mortality. Secondary outcomes included length of pediatric intensive care unit stay and total hospital stay, duration of conventional mechanical ventilation and extracorporeal membrane oxygenation, and secondary infection rates. Patients were stratified by CS exposure (CS group) versus standard therapy (non-CS group). Among 129 eligible children, 97 (75.2%) received CSs and 32 (24.8%) received standard therapy. Baseline characteristics demonstrated no significant differences (P > .05). The CS group exhibited significantly higher secondary infection rates (89.9% vs 75.0%, P = .038) and mortality (24.7% vs 6.3%, P = .023). Adenovirus predominated in both cohorts (CS: 50.5%, non-CS: 62.5%), followed by influenza A…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 129 participants or records.
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