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...

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Detalhes bibliográficos
Autores: Gómez Muñoz, Ana María, Fernández-Cruz, Ana, Lavilla Olleros, Cristina, Giner-Galvañ, Vicente, Ausín-García, Cristina, Wikman-Jorgensen, Philip Erick, Vargas, Juan A., Rubio-Rivas, Manuel, Laureiro, Jaime, Fernández-Bermúdez, Daniel, Buonaiuto, Verónica A., Arenas de Larriva, Antonio P., Pascual-Pérez, María de los Reyes, Alcalá-Pedrajas, José N., Labirua-Iturburu Ruiz, Ane
Tipo de documento: artigo
Data de publicação:2021
País:España
Recursos:Universidad Miguel Hernández de Elche
Repositório:REDIUMH. Depósito Digital de la UMH
OAI Identifier:oai:dspace.umh.es:11000/35257
Acesso em linha:https://hdl.handle.net/11000/35257
Access Level:Acceso aberto
Palavra-chave:corticosteroids
SARS-CoV-2
COVID-19
mortality
Descrição
Resumo: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.

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