Selected article for: "corticosteroid treatment and retrospective study"
Author: Cusacovich, Ivan; Aparisi, Álvaro; Marcos, Miguel; Ybarra-Falcón, Cristina; Iglesias-Echevarria, Carolina; Lopez-Veloso, Maria; Barraza-Vengoechea, Julio; Dueñas, Carlos; Juarros Martínez, Santiago Antonio; Rodríguez-Alonso, Beatriz; Martín-Oterino, José-Ángel; Montero-Baladia, Miguel; Moralejo, Leticia; Andaluz-Ojeda, David; Gonzalez-Fuentes, Roberto
Title: Corticosteroid Pulses for Hospitalized Patients with COVID-19: Effects on Mortality
  • Cord-id: nz3rwwbb
  • Document date: 2021_3_12
    • ID: nz3rwwbb
    Snippet: OBJECTIVES: To assess the influence of corticosteroid pulses on 60-day mortality in hospitalized patients with severe COVID-19. METHODS: We designed a multicenter retrospective cohort study in three teaching hospitals of Castilla y León, Spain (865,096 people). We selected patients with confirmed COVID-19 and lung involvement with a pO2/FiO2<300, excluding those exposed to immunosuppressors before or during hospitalization, patients terminally ill at admission, or those who died in the first 24
    Document: OBJECTIVES: To assess the influence of corticosteroid pulses on 60-day mortality in hospitalized patients with severe COVID-19. METHODS: We designed a multicenter retrospective cohort study in three teaching hospitals of Castilla y León, Spain (865,096 people). We selected patients with confirmed COVID-19 and lung involvement with a pO2/FiO2<300, excluding those exposed to immunosuppressors before or during hospitalization, patients terminally ill at admission, or those who died in the first 24 hours. We performed a propensity score matching (PSM) adjusting covariates that modify the probability of being treated. Then, we used a Cox regression model in the PSM group to consider factors affecting mortality. RESULTS: From 2933 patients, 257 fulfilled the inclusion and exclusion criteria. 124 patients were on corticosteroid pulses (250 mg of methylprednisolone for three days), and 133 were not. 30.3% (37/122) of patients died in the corticosteroid pulse group and 42.9% (57/133) in the nonexposed cohort. These differences (12.6%, 95% CI [8·54-16.65]) were statically significant (log-rank 4.72, p = 0, 03). We performed PSM using the exact method. Mortality differences remained in the PSM group (log-rank 5.31, p = 0.021) and were still significant after a Cox regression model (HR for corticosteroid pulses 0.561; p = 0.039). CONCLUSIONS: This study provides evidence about treatment with corticosteroid pulses in severe COVID-19 that might significantly reduce mortality. Strict inclusion and exclusion criteria with that selection process set a reliable frame to compare mortality in both the exposed and nonexposed groups.

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