{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:32:20Z","timestamp":1790685140406,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T00:00:00Z","timestamp":1496966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["2015BAI12B11"],"award-info":[{"award-number":["2015BAI12B11"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The effect of corticosteroids on influenza A(H1N1)pdm09 viral pneumonia patients remains controversial, and the impact of dosage has never been studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data of hospitalized adolescent and adult patients with influenza A(H1N1)pdm09 viral pneumonia, prospectively collected from 407 hospitals in mainland China, the effects of low\u2010to\u2010moderate\u2010dose (25\u2010150\u00a0mg\u00a0d<jats:sup>\u22121<\/jats:sup>) and high\u2010dose (&gt;150\u00a0mg\u00a0d<jats:sup>\u22121<\/jats:sup>) corticosteroids on 30\u2010day mortality, 60\u2010day mortality, and nosocomial infection were assessed with multivariate Cox regression and propensity score\u2010matched case\u2013control analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 2141 patients (median age: 34 years; morality rate: 15.9%) were included. Among them, 1160 (54.2%) had PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>&lt;300\u00a0mm\u00a0Hg on admission, and 1055 (49.3%) received corticosteroids therapy. Corticosteroids, without consideration of dose, did not influence either 30\u2010day or 60\u2010day mortality. Further analysis revealed that, as compared with the no\u2010corticosteroid group, low\u2010to\u2010moderate\u2010dose corticosteroids were related to reduced 30\u2010day mortality (adjusted hazard ratio [<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>] 0.64 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.43\u20100.96, <jats:italic>P<\/jats:italic>=.033]). In the subgroup analysis among patients with PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>&lt;300\u00a0mm\u00a0Hg, low\u2010to\u2010moderate\u2010dose corticosteroid treatment significantly reduced both 30\u2010day mortality (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 0.49 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.32\u20100.77]) and 60\u2010day mortality (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 0.51 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.33\u20100.78]), while high\u2010dose corticosteroid therapy yielded no difference. For patients with PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> \u2265300\u00a0mm\u00a0Hg, corticosteroids (irrespective of dose) showed no benefit and even increased 60\u2010day mortality (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 3.02 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.06\u20108.58]). Results were similar in the propensity model analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low\u2010to\u2010moderate\u2010dose corticosteroids might reduce mortality of influenza A(H1N1)pdm09 viral pneumonia patients with PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>&lt;300\u00a0mm\u00a0Hg. Mild patients with PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> \u2265300\u00a0mm\u00a0Hg could not benefit from corticosteroid therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.12456","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T17:29:57Z","timestamp":1493746197000},"page":"345-354","source":"Crossref","is-referenced-by-count":114,"title":["Effect of low\u2010to\u2010moderate\u2010dose corticosteroids on mortality of hospitalized adolescents and adults with influenza A(H1N1)pdm09 viral pneumonia"],"prefix":"10.1111","volume":"11","author":[{"given":"Hui","family":"Li","sequence":"first","affiliation":[{"name":"Beijing Chao\u2010Yang Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010gui","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases The\u00a0First Affiliated Hospital College of Medicine Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Gu","sequence":"additional","affiliation":[{"name":"Beijing Chao\u2010Yang Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Global Health, Population &amp; Nutrition Global Research &amp; Services Family Health International 360  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi\u2010xin","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Second Hospital of Hebei Medical University  Shijiazhuang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong\u2010an","family":"Liang","sequence":"additional","affiliation":[{"name":"West China Hospital of Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong\u2010yu","family":"Jia","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases The\u00a0First Affiliated Hospital College of Medicine Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Chao\u2010Yang Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010jiang","family":"Yu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Harbin Medical University  Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010xue","family":"Xue","sequence":"additional","affiliation":[{"name":"Beijing Chao\u2010Yang Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Hu","sequence":"additional","affiliation":[{"name":"Renmin Hospital of Wuhan University  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zou","sequence":"additional","affiliation":[{"name":"Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan\u2010juan","family":"Li","sequence":"additional","affiliation":[{"name":"State Key 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