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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Authors: Munoz-Gomez, A, Fernandez-Cruz, A, Lavilla-Olleros, C, Giner-Galvan, V, Ausin-Garcia, C, Wikman, P, Bendala-Estrada, AD, Vargas, JA, Rubio-Rivas, M, Laureiro, J, Fernandez-Bermudez, D, Buonaiuto, VA, de Larriva, AAP, Pascual-Perez, MD, Alcala-Pedrajas, JN, Ruiz, ALI, Hernandez-Milian, A, del Mazo, MG, Antequera, B, Mella-Perez, C, Navas-Alcantara, MD, Soto-Delgado, JF, Gamez-Mancera, RM, Sardina-Gonzalez, C, Meijide-Miguez, H, Ramos-Rincon, JM, Gomez-Huelgas, R, Network
Format: article
Status:Published version
Publication Date:2021
Country:España
Institution:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repository:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p8362
Online Access:https://isabial.portalinvestigacion.com/publicaciones8362
Access Level:Open access
Keyword:corticosteroids
SARS-CoV-2
COVID-19
mortality
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spelling Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective StudyMunoz-Gomez, AFernandez-Cruz, ALavilla-Olleros, CGiner-Galvan, VAusin-Garcia, CWikman, PBendala-Estrada, ADVargas, JARubio-Rivas, MLaureiro, JFernandez-Bermudez, DBuonaiuto, VAde Larriva, AAPPascual-Perez, MDAlcala-Pedrajas, JNRuiz, ALIHernandez-Milian, Adel Mazo, MGAntequera, BMella-Perez, CNavas-Alcantara, MDSoto-Delgado, JFGamez-Mancera, RMSardina-Gonzalez, CMeijide-Miguez, HRamos-Rincon, JMGomez-Huelgas, RNetworkcorticosteroidsSARS-CoV-2COVID-19mortalityWe 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.</p>MDPI2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones8362Journal of Clinical MedicineISSN: 20770383reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p83622026-06-12T10:20:37Z
dc.title.none.fl_str_mv Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
title Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
spellingShingle Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
Munoz-Gomez, A
corticosteroids
SARS-CoV-2
COVID-19
mortality
title_short Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
title_full Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
title_fullStr Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
title_full_unstemmed Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
title_sort Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
dc.creator.none.fl_str_mv Munoz-Gomez, A
Fernandez-Cruz, A
Lavilla-Olleros, C
Giner-Galvan, V
Ausin-Garcia, C
Wikman, P
Bendala-Estrada, AD
Vargas, JA
Rubio-Rivas, M
Laureiro, J
Fernandez-Bermudez, D
Buonaiuto, VA
de Larriva, AAP
Pascual-Perez, MD
Alcala-Pedrajas, JN
Ruiz, ALI
Hernandez-Milian, A
del Mazo, MG
Antequera, B
Mella-Perez, C
Navas-Alcantara, MD
Soto-Delgado, JF
Gamez-Mancera, RM
Sardina-Gonzalez, C
Meijide-Miguez, H
Ramos-Rincon, JM
Gomez-Huelgas, R
Network
author Munoz-Gomez, A
author_facet Munoz-Gomez, A
Fernandez-Cruz, A
Lavilla-Olleros, C
Giner-Galvan, V
Ausin-Garcia, C
Wikman, P
Bendala-Estrada, AD
Vargas, JA
Rubio-Rivas, M
Laureiro, J
Fernandez-Bermudez, D
Buonaiuto, VA
de Larriva, AAP
Pascual-Perez, MD
Alcala-Pedrajas, JN
Ruiz, ALI
Hernandez-Milian, A
del Mazo, MG
Antequera, B
Mella-Perez, C
Navas-Alcantara, MD
Soto-Delgado, JF
Gamez-Mancera, RM
Sardina-Gonzalez, C
Meijide-Miguez, H
Ramos-Rincon, JM
Gomez-Huelgas, R
Network
author_role author
author2 Fernandez-Cruz, A
Lavilla-Olleros, C
Giner-Galvan, V
Ausin-Garcia, C
Wikman, P
Bendala-Estrada, AD
Vargas, JA
Rubio-Rivas, M
Laureiro, J
Fernandez-Bermudez, D
Buonaiuto, VA
de Larriva, AAP
Pascual-Perez, MD
Alcala-Pedrajas, JN
Ruiz, ALI
Hernandez-Milian, A
del Mazo, MG
Antequera, B
Mella-Perez, C
Navas-Alcantara, MD
Soto-Delgado, JF
Gamez-Mancera, RM
Sardina-Gonzalez, C
Meijide-Miguez, H
Ramos-Rincon, JM
Gomez-Huelgas, R
Network
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv corticosteroids
SARS-CoV-2
COVID-19
mortality
topic corticosteroids
SARS-CoV-2
COVID-19
mortality
description 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.</p>
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones8362
url https://isabial.portalinvestigacion.com/publicaciones8362
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine
ISSN: 20770383
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423786855497728
score 15.812429

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