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Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patien...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540860/ https://www.ncbi.nlm.nih.gov/pubmed/34682801 http://dx.doi.org/10.3390/jcm10204678 |
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author | Muñoz-Gómez, Ana Fernández-Cruz, Ana Lavilla-Olleros, Cristina Giner-Galvañ, Vicente Ausín-García, Cristina Wikman, Philip Bendala-Estrada, Alejandro D. Vargas, Juan A. Rubio-Rivas, Manuel Laureiro, Jaime Fernández-Bermúdez, Daniel Buonaiuto, Verónica A. Arenas de Larriva, Antonio P. Pascual-Pérez, María de los Reyes Alcalá-Pedrajas, José N. Labirua-Iturburu Ruiz, Ane Hernández-Milián, Almudena Gómez del Mazo, Marta Antequera, Beatriz Mella-Pérez, Carmen Navas-Alcántara, María de la Sierra Soto-Delgado, Juan F. Gámez-Mancera, Rosa M. Sardiña-González, Cristina Meijide-Míguez, Héctor Ramos-Rincón, José M. Gómez-Huelgas, Ricardo |
author_facet | Muñoz-Gómez, Ana Fernández-Cruz, Ana Lavilla-Olleros, Cristina Giner-Galvañ, Vicente Ausín-García, Cristina Wikman, Philip Bendala-Estrada, Alejandro D. Vargas, Juan A. Rubio-Rivas, Manuel Laureiro, Jaime Fernández-Bermúdez, Daniel Buonaiuto, Verónica A. Arenas de Larriva, Antonio P. Pascual-Pérez, María de los Reyes Alcalá-Pedrajas, José N. Labirua-Iturburu Ruiz, Ane Hernández-Milián, Almudena Gómez del Mazo, Marta Antequera, Beatriz Mella-Pérez, Carmen Navas-Alcántara, María de la Sierra Soto-Delgado, Juan F. Gámez-Mancera, Rosa M. Sardiña-González, Cristina Meijide-Míguez, Héctor Ramos-Rincón, José M. Gómez-Huelgas, Ricardo |
author_sort | Muñoz-Gómez, Ana |
collection | PubMed |
description | We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March–July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients. |
format | Online Article Text |
id | pubmed-8540860 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85408602021-10-24 Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study Muñoz-Gómez, Ana Fernández-Cruz, Ana Lavilla-Olleros, Cristina Giner-Galvañ, Vicente Ausín-García, Cristina Wikman, Philip Bendala-Estrada, Alejandro D. Vargas, Juan A. Rubio-Rivas, Manuel Laureiro, Jaime Fernández-Bermúdez, Daniel Buonaiuto, Verónica A. Arenas de Larriva, Antonio P. Pascual-Pérez, María de los Reyes Alcalá-Pedrajas, José N. Labirua-Iturburu Ruiz, Ane Hernández-Milián, Almudena Gómez del Mazo, Marta Antequera, Beatriz Mella-Pérez, Carmen Navas-Alcántara, María de la Sierra Soto-Delgado, Juan F. Gámez-Mancera, Rosa M. Sardiña-González, Cristina Meijide-Míguez, Héctor Ramos-Rincón, José M. Gómez-Huelgas, Ricardo J Clin Med Article We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March–July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients. MDPI 2021-10-13 /pmc/articles/PMC8540860/ /pubmed/34682801 http://dx.doi.org/10.3390/jcm10204678 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Muñoz-Gómez, Ana Fernández-Cruz, Ana Lavilla-Olleros, Cristina Giner-Galvañ, Vicente Ausín-García, Cristina Wikman, Philip Bendala-Estrada, Alejandro D. Vargas, Juan A. Rubio-Rivas, Manuel Laureiro, Jaime Fernández-Bermúdez, Daniel Buonaiuto, Verónica A. Arenas de Larriva, Antonio P. Pascual-Pérez, María de los Reyes Alcalá-Pedrajas, José N. Labirua-Iturburu Ruiz, Ane Hernández-Milián, Almudena Gómez del Mazo, Marta Antequera, Beatriz Mella-Pérez, Carmen Navas-Alcántara, María de la Sierra Soto-Delgado, Juan F. Gámez-Mancera, Rosa M. Sardiña-González, Cristina Meijide-Míguez, Héctor Ramos-Rincón, José M. Gómez-Huelgas, Ricardo Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title | Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title_full | Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title_fullStr | Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title_full_unstemmed | Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title_short | Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study |
title_sort | real-life impact of glucocorticoid treatment in covid-19 mortality: a multicenter retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540860/ https://www.ncbi.nlm.nih.gov/pubmed/34682801 http://dx.doi.org/10.3390/jcm10204678 |
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