The Impact of Corticosteroid Therapy on Patients With West Nile Virus: A Retrospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: West Nile virus (WNV) infection may result in a serious, neuroinvasive, life-threatening disease. Since there is no known therapy against the virus, treatment is based on supportive care. Little is known about the effect of corticosteroids (CS) in patients with West Nile, and their use remains controversial. This study aimed to evaluate the effect of CS treatment in patients with WNV infection. METHODS: A retrospective cohort study was conducted at Rabin Medical Center, including patients with WNV infection. Data were extracted from patients' electronic medical records. Inverse probability of treatment weighting was used to adjust patient characteristics. Our exposure of interest was CS prescription during the first 48 hours. IPTW-adjusted Cox proportional hazard models were used to compare the risk of hospital mortality. Secondary outcomes included the need for mechanical ventilation or intensive care unit transfer, and the need for rehabilitation or a long-term care facility at discharge. RESULTS: Data from 150 confirmed cases were extracted. 41 (27%) patients received CSs. After adjusting for potential confounders, CS treatment was found to significantly increase hospital mortality (adjusted hazard ratio [aHR] 3.93, 95% confidence interval [CI] 1.14-13.51). A sensitivity analysis including patients with West Nile neuroinvasive disease and patients hospitalized for more than 48 hours showed consistent results. CONCLUSIONS: Our study suggests that CS use in WNV patients may be associated with an increased risk of hospital mortality, highlighting the need for caution in their use and further prospective investigation.
Institutions: Tel Aviv University, Rabin Medical Center
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
OpenAlex ID: W4417046093