Investigation of factors influencing intravenous glucocorticoid treatment course in severe acute urticaria: A retrospective study

Acute urticaria, a prevalent skin condition characterized by wheals and itching, often requires intravenous glucocorticoids for patients with severe symptoms and systemic manifestations. However, clinical studies investigating factors influencing the intravenous glucocorticoid treatment course in patients with severe acute urticaria are lacking. This retrospective study examines factors influencing intravenous corticosteroid treatment in severe acute urticaria and compares the characteristics of patients with and without infection. This study enrolled 96 patients with severe acute urticaria. Baseline data – sex, age, region, season, accompanying symptoms, triggers, glucocorticoid types, initial dose, neutrophil, platelet, lymphocyte, white blood cell counts, Urticaria Activity Score, and treatment duration were meticulously recorded for each participant. Spearman correlation, Mann–Whitney U and Kruskal–Wallis H tests explored relationships between the treatment course of intravenous glucocorticoids and continuous or categorical variables. Statistically significant variables identified in the univariate analysis were tested using multiple linear regression analysis. Chi-square tests or Spearman correlation were used to compare differences between the infection-triggered and non-infection-triggered groups. Multiple linear regression analysis revealed infection (β = 0.05, [95% confidence interval: 0.02–2.09], P < .05) and elevated neutrophils (β = 1.47, [95% confidence interval: 0.09–2.85], P < .05) to be significantly associated with a prolonged duration of intravenous glucocorticoid therapy in severe acute urticaria patients. No significant differences were observed between infectious and noninfectious acute urticaria groups in the subgroup analysis. Infection and elevated neutrophil count were associated with prolonged intravenous glucocorticoid courses. Investigating other laboratory indicators associated with infection-triggered severe acute urticaria, rather than the neutrophil, lymphocyte, and white blood cell levels, is recommended.