STEROIDS AND MORTALITY IN NON-CRITICALLY ILL COVID-19 PATIENTS: A PROPENSITY SCORE WEIGHTED STUDY IN A CHILEAN COHORT

Moreno, A.; Vargas, C.; Azocar, F.; Villarroel, F.; Cofré, M.; Oppliger, H.; Ríos, F.; Raijmakers, M.; Silva, I.; Beltrán, C.; Zamora, F.

Objectives Evaluate the impact on 30-day mortality of early use of corticosteroids in patients with COVID-19 with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. Methods Between April 15th and July 15th, 2020, all hospitalized patients with COVID-19 and oxygen requirements were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticoids within the first 5 days of hospitalization and at least 24 hours prior to intubation were considered as in “early corticosteroids group.” To compare both populations and adjust for non-random treatment assignment bias a weight adjusted propensity score model was used. Results 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. After the analysis, a reduction of 8.5% (p = 0.038) in 30 -day mortality was observed in the early corticosteroid group. The reduction in mortality was nonsignificant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. Conclusion Early corticosteroid use in patients with pneumonia due to COVID-19 and supplementary oxygen requirements without invasive mechanical ventilation reduces mortality.