Back to Search
Start Over
Corticosteroids in patients hospitalized for COVID-19 pneumonia who require oxygen: observational comparative study using routine care data
- Source :
- Clinical Microbiology and Infection
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- OBJECTIVE: To assess the effectiveness of corticosteroids on outcomes of patients with COVID-19 pneumonia requiring oxygen without mechanical ventilation. METHODS: We used routine care data from 51 hospitals in France and Luxembourg to assess the effectiveness of corticosteroids at 0.8 mg/kg/day eq. prednisone (CTC group) versus standard of care (no-CTC group) among adults 18 to 80 years old with confirmed COVID-19 pneumonia requiring oxygen without mechanical ventilation. The primary outcome was intubation or death by day 28. In our main analysis, characteristics of patients at baseline (i.e., time when patients met all inclusion criteria) were balanced by using propensity-score inverse probability of treatment weighting. RESULTS: Among the 891 patients included in the analysis, 203 were assigned to the CTC group. Use of corticosteroids was not significantly associated with risk of intubation or death by day 28 (weighted hazard ratio [wHR] 0.92, 95% CI 0.61 to 1.39) or cumulative death rate (wHR 1.03, 95% CI 0.54 to 1.98). However, use of corticosteroids was associated with reduced risk of intubation or death by day 28 in the prespecified subgroups of patients requiring oxygen ≥ 3 L/min (wHR 0.50, 95% CI 0.30 to 0.85) or C-reactive protein level ≥ 100 mg/L (wHR 0.44, 95%CI 0.23 to 0.85). Number of hyperglycaemia events was higher for patients with than without corticosteroids, but number of infections was similar. CONCLUSIONS: We found no association between the use of corticosteroids and intubation or death in the broad population of patients 18 to 80 years old with COVID-19 hospitalized in non-intensive care unit settings. However, the treatment was associated with reduced risk of intubation or death for patients with ≥ 3 L/min oxygen or C-reactive protein level ≥ 100 mg/L at baseline. Further research need to confirm the right timing of corticosteroids for patients with COVID-19 requiring oxygen only.
- Subjects :
- 0301 basic medicine
Adult
Male
Microbiology (medical)
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Therapeutic evaluation
030106 microbiology
Population
Severity of Illness Index
03 medical and health sciences
Young Adult
0302 clinical medicine
Prednisone
Adrenal Cortex Hormones
Internal medicine
Observational study
Severity of illness
Medicine
Intubation
Corticosteroids
Humans
030212 general & internal medicine
education
Aged
Mechanical ventilation
Aged, 80 and over
education.field_of_study
business.industry
Mortality rate
Hazard ratio
Oxygen Inhalation Therapy
COVID-19
General Medicine
Middle Aged
medicine.disease
Respiration, Artificial
COVID-19 Drug Treatment
Pneumonia
C-Reactive Protein
Infectious Diseases
Original Article
Female
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 1198743X
- Database :
- OpenAIRE
- Journal :
- Clinical Microbiology and Infection
- Accession number :
- edsair.doi.dedup.....acece7701ab5dc72fb1f05bb54a81199
- Full Text :
- https://doi.org/10.1016/j.cmi.2020.11.035