Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study

We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patien...

Descripción completa

Detalles Bibliográficos
Autores: Muñoz Gómez, Ana, Fernández Cruz, Ana, Lavilla Olleros, Cristina, Giner Galvañ, Vicente, Ausín García, Cristina, Wikman, Philip, Bendala Estrada, Alejandro David, Vargas Núñez, Juan Antonio, Rubio Rivas, Manuel, Laureiro, Jaime, Fernández Bermúdez, Daniel, Buonaiuto, Verónica A., Arenas de Larriva, Antonio P., Pascual Pérez, Maria de los Reyes, Alcalá Pedrajas, José Nicolás, Labirua-Iturburu Ruiz, Ane, Hernández Milián, Almudena, Gómez del Mazo, Marta, Antequera, Beatriz, Mella Pérez, Carmen, Navas Alcántara, María, Soto Delgado, Juan F., Gámez Mancera, Rosa M., Sardiña González, Cristina, Meijide Míguez, Héctor, Ramos-Rincón, José Manuel, Gómez Huelgas, Ricardo, On Behalf of the SEMI-COVID-19 Network
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/181361
Acceso en línea:https://hdl.handle.net/2445/181361
Access Level:acceso abierto
Palabra clave:COVID-19
Cortisona
Mortalitat
Cortisone
Mortality
Descripción
Sumario:We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March-July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients.

Similares en LA Referencia