Objective: To investigate the response to high-dose corticosteroids according to bronchoalveolar neutrophil-to-lymphocyte ratio (BAL-NLR) in critically-ill COVID-19 patients.
Methods: We retrospectively analyzed a single-center cohort of adult COVID-19 patients admitted to the intensive care unit with COVID-19 pneumonia between 2020 and 2022, who had a bronchoalveolar lavage and received systemic corticosteroids. We defined high-dose corticosteroid therapy as the administration of at least 1mg/kg/day of methylprednisolone.
Results: Among 161 patients, 56 had LOW (<0.8), 55 MILD (0.8-3.5), and 50 HIGH (>3.5). A quarter of patients received high-dose corticosteroid therapy. In the HIGH group, those receiving high-dose corticosteroid therapy had a lower (27 % versus 43 %, p = 0.23) 90-day mortality rate than those receiving a standard dose. In the LOW group, those receiving high-dose corticosteroid therapy had a higher (31 % versus 12 %, p = 0.12) 90-day mortality rate.
Conclusion: Our results suggest that bronchoalveolar cellular phenotype influences therapeutic response to high-dose corticosteroid therapy.
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| http://dx.doi.org/10.1016/j.idnow.2025.105054 | DOI Listing |
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