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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,
Corresponding author
asalinasbotran@yahoo.es

Corresponding authors.
, L.M. Pérez-Belmonteb,
Corresponding author
luismiguelpb1984@gmail.com

Corresponding authors.
, M. Méndez-Bailóna, en representación del grupo SEMI-COVID-19 Network
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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        "titulo" => "Respuesta a la carta &#171;Tratamiento con glucocorticoides en pacientes con COVID-19 e insuficiencia card&#237;aca concurrente&#187;"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We are grateful for the comments on our article &#8220;Clinical characteristics and risk factors for mortality upon admission in patients with heart failure hospitalized due to COVID-19 in Spain&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Indeed&#44; glucocorticoid &#40;GC&#41; use was greater in patients with heart failure &#40;HF&#41; hospitalized for COVID-19 who died&#46; This can be explained by the effects of the mineralocorticoid and sodium and water retention&#44; as the letter&#8217;s authors correctly indicate&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Unfortunately&#44; we do not have specific data regarding the type of GC used&#59; the only data recorded were whether they were used or not&#44; the dose used&#44; and the duration of treatment &#40;SEMI-COVID-19 Registry&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However&#44; the following considerations should be noted&#58;</p><p id="par0015" class="elsevierStylePara elsevierViewall">First&#44; the most used GC during the first wave of the epidemic in Spain was methylprednisolone&#44; as a recent article indicated&#46;<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&#44; it was used less in our country during the first wave&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Second&#44; the initial multivariable analysis conducted in our study included patients&#8217; baseline clinical variables at the time of admission and did not include variables regarding treatment administered&#46; We are currently working on a larger&#44; more focused database in order to discern the effect of treatment&#44; including the use of GC &#40;especially dexamethasone&#41; on this profile of patient&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Lastly&#44; and in contrast to the possible deleterious effect of GC in patients with HF&#44; it should be noted that some recent works have demonstrated the utility of other drugs in patients with HF during hospitalization for COVID-19&#46; 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&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion&#44; according to our results&#44; GC should be used with caution in patients with HF&#44; weighing their risks and benefits&#46; More prospective&#44; controlled studies on the use of GC in patients with HF and COVID-19 are needed to confirm these results&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Salinas-Botr&#225;n A&#44; P&#233;rez-Belmonte LM&#44; M&#233;ndez-Bail&#243;n M&#46; Respuesta a la carta &#171;Tratamiento con glucocorticoides en pacientes con COVID-19 e insuficiencia card&#237;aca concurrente&#187;&#46; Rev Cl&#237;n Esp&#46; 2022&#59;222&#58;311&#8211;312&#46;</p>"
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Article information
ISSN: 22548874
Original language: English
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