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...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: A. Moreno, C. Vargas, F. Azocar, F. Villarroel, M. Cofré, H. Oppliger, F. Ríos, M. Raijmakers, I. Silva-Ayarza, C. Beltrán, F. Zamora
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://doaj.org/article/19290fb3c904465b906f46b56be3c7dd
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
Descripción
Sumario: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.