Effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19: A retrospective cohort study

Xiong, Bin; He, Li-Min; Qin, Yuan-Yuan; Du, Hu; Zhan, Zhu; Zhou, Yi-Hong; Chen, Yao-Kai; Zhang, An

BACKGROUND: The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019 (COVID-19) remains inconclusive. AIM: To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19. METHODS: We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy (the corticosteroid group) and patients with severe COVID-19 who did not receive corticosteroid therapy (the non-corticosteroid group). RESULTS: Seventy-five patients were included in this study. Of these, 47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group. There were no differences between the two groups in the total length of hospital stay, the length of intensive care unit stay, high-flow oxygen days, non-invasive ventilator days, invasive ventilation days, and mortality rate. Total lesion volume ratio, consolidation volume ratio and ground-glass opacity volume ratio in the corticosteroid group decreased significantly on day 14, while those in the non-corticosteroid group did not show a significant decrease. CONCLUSION: Our results show that adjunctive corticosteroid use did not significantly improve clinical outcomes in severe COVID-19 patients, but might promote the absorption of pulmonary lesions. Larger multicenter randomized controlled studies may be needed to confirm this.