Corticosteroid Use in the Treatment of COVID-19: A Multicenter Retrospective Study in Hunan, China

Ma, Yiming; Zeng, Huihui; Zhan, Zijie; Lu, Huanhuan; Zeng, Zihang; He, Chenjie; Liu, Xiangming; Chen, Chen; Qin, Qingwu; He, Jia; Zhou, Zhiguo; Huang, Peng; Jiang, Mingyan; Deng, Dingding; Liao, Xin; Xiang, Zhi; Huang, Xiaoying; Chen, Yan; Chen, Ping

BACKGROUND: Coronavirus disease 2019 (COVID-19) has developed into a worldwide pandemic. This study aimed to retrospectively describe the use of corticosteroids in treating COVID-19. METHODS: For this multicenter retrospective study, medical records from 488 symptomatic COVID-19 patients were reviewed. Patients were divided into severe and nonsevere groups. Baseline characteristics, signs and symptoms, laboratory findings, treatments, and disease outcomes were compared. Specific data for corticosteroid treatment were further analyzed. RESULTS: Four hundred fifty COVID-19 patients were included in this study, including 82 severe patients and 368 nonsevere cases. Out of the 450 patients, 126 (28.0%) received corticosteroid treatment. In the 126 patients treated with corticosteroids, the median daily dose of corticosteroid therapy was 56.6 [interquartile range (IQR): 40.0–78.4] mg and median corticosteroid therapy duration was 5.0 (IQR: 3.0–7.0) days. Among nonsevere cases, patients treated with corticosteroids were significantly older in comparison with patients who did not receive corticosteroid treatment (p<0.01); the proportion of patients receiving antibiotic therapy in the corticosteroid group was significantly higher than that in the noncorticosteroid group (p<0.001); hospitalization length and duration of viral shedding were significantly longer in patients in the corticosteroid group than in the noncorticosteroid group after adjusting for age, sex, and comorbidities (p<0.05). In severe cases, patients treated with corticosteroids were significantly older and comorbidities at admission were significantly more common in patients receiving corticosteroid treatment (p<0.05); the proportion of patients receiving antibiotic therapy in the corticosteroid group was significantly higher than that in the noncorticosteroid group (p<0.001); no significant difference in hospitalization length or viral shedding duration was found between two groups after adjusting for age, sex, and comorbidities (p>0.05). CONCLUSION: Our study indicates that corticosteroids are regarded as one of treatments in the general clinical practice of COVID-19. However, corticosteroid use may be accompanied by increased use of antibiotics, longer hospitalization, and prolonged viral shedding.