In-hospital mortality in SARS-CoV-2 stratified by the use of corticosteroid

OBJECTIVE: To investigate COVID-19 related mоrtаlity according to the use of corticosteroid therapy. DESIGN: Retrospective cohort study. SETTING: Two tertiary hospitals in Kuwait. PARTICIPANTS: Overall, 962 patients with confirmed SARS-CoV-2 infection, were stratified according to whether they were treated with corticosteroids (dexamethasone or methylprednisolone). The mean age of the patients was 50.2 ± 15.9 years and 344/962 (35.9%) were female. MAIN OUTCOME MEASURES: In-hospital mortality and cumulative all-cause mortality. RESULTS: Compared to non-corticosteroid therapy patients, corticosteroid therapy patients had a higher prevalence of hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease, and chronic kidney disease; a longer hospital stay (median [IQR]: 17.0 [5.0–57.3] days vs 14.0 [2.0–50.2] days); and a higher in-hospital mortality (51/199 [25.6%] vs 36/763 [4.7%]). Logistic regression analysis showed a higher in-hospital mortality in the corticosteroid group (adjusted odds ratio [aOR]: 4.57, 95% confidence interval [CI]: 2.64–8.02, p < 0.001). Cox proportional hazards regression showed that corticosteroid use was a significant predictor of mortality (hazard ratio [HR]: 3.96, p < 0.001). CONCLUSIONS: In-hospital mortality in patients with SARS-CoV-2 on corticosteroid therapy was 4.6 times higher than in those without corticosteroid therapy.