Steroids and mortality in non‐critically ill COVID‐19 patients: a propensity score‐weighted study in a Chilean cohort
Objectives: The aim of this study was to evaluate the impact on 30-day mortality of early use of corticosteroids in COVID-19 patients with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. Methods: All patients hospitalized with COVID-19 betw...
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Main Authors: | , , , , , , , , , , |
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Format: | article |
Language: | EN |
Published: |
Elsevier
2021
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Subjects: | |
Online Access: | https://doaj.org/article/19290fb3c904465b906f46b56be3c7dd |
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Summary: | Objectives: The aim of this study was to evaluate the impact on 30-day mortality of early use of corticosteroids in COVID-19 patients with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. Methods: All patients hospitalized with COVID-19 between April 15 and July 15, 2020, and requiring supplementary oxygen, were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticosteroids within the first 5 days of hospitalization and at least 24 hours prior to intubation were allocated to the ‘early corticosteroids’ group. To compare both populations and adjust for non-random treatment assignment bias, a weight-adjusted propensity score model was used. Results: In total, 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. Analysis showed a reduction of 8.5% (p = 0.038) in 30-day mortality in the early corticosteroid group. The reduction in mortality was not significant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. Conclusion: Early corticosteroid use reduced mortality in patients with pneumonia due to COVID-19, who required supplementary oxygen but not initial invasive mechanical ventilation. |
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