Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease

Abstract There is a paucity of studies investigating the impact of chronic corticosteroid use for coexisting conditions in patients with Coronavirus Disease 2019 (COVID-19). Additionally, the information regarding the impact of chronic liver disease (CLD) on COVID-19 outcomes is evolving. Our study...

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Autores principales:	Hammad Liaquat, Brittney Shupp, Samantha Rollins, Yecheskel Schneider, Ayaz Matin
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/40ee2b3596364b299ad14193c36c6616
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spelling	oai:doaj.org-article:40ee2b3596364b299ad14193c36c66162021-12-02T17:17:40ZComparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease10.1038/s41598-021-98778-z2045-2322https://doaj.org/article/40ee2b3596364b299ad14193c36c66162021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98778-zhttps://doaj.org/toc/2045-2322Abstract There is a paucity of studies investigating the impact of chronic corticosteroid use for coexisting conditions in patients with Coronavirus Disease 2019 (COVID-19). Additionally, the information regarding the impact of chronic liver disease (CLD) on COVID-19 outcomes is evolving. Our study aims to investigate hospitalization outcomes of patients with COVID-19 on long term corticosteroids for coexisting conditions while also seeking to compare outcomes between such patients with a history of CLD to analyze the impact on mortality. We conducted a retrospective chart review across our 10-hospital network identifying patients on chronic corticosteroids (Prednisone ≥ 5 mg daily dose or equivalent dose of another steroid, for a duration of 30 days or more) who were hospitalized with COVID-19 from March 1, 2020 to June 30, 2020. Of these patients who met inclusion criteria, patients were then divided into groups based upon their history of CLD. Primary outcomes of the study looked to investigate the hospitalization outcomes of patients with a history of CLD and comorbid conditions requiring chronic corticosteroid use. Secondary outcomes sought to further investigate risk factors for mortality in our study sample. 837 charts were reviewed. 139 patients met inclusion criteria of which 34 patients had a history of CLD. Statistical analysis demonstrated no difference in length of hospital stay but increased ICU admission rate in the CLD group (41.2% vs 23.8%). No statistically significant difference was seen in between the CLD and non-CLD groups in term of complication rates and 28-day mortality. However, chronic corticosteroids patients were found to have higher rates of ICU admission and overall 28-day and ICU mortality in comparison to patients who were not on chronic corticosteroids prior to COVID-19 hospitalization. The larger contributor to COVID-19 severity was likely chronic corticosteroid use rather than CLD and thus chronic corticosteroid use should be limited throughout the COVID-19 pandemic especially in patients with additional speculated risk factors for COVID-19 such as CLD.Hammad LiaquatBrittney ShuppSamantha RollinsYecheskel SchneiderAyaz MatinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hammad Liaquat Brittney Shupp Samantha Rollins Yecheskel Schneider Ayaz Matin Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
description	Abstract There is a paucity of studies investigating the impact of chronic corticosteroid use for coexisting conditions in patients with Coronavirus Disease 2019 (COVID-19). Additionally, the information regarding the impact of chronic liver disease (CLD) on COVID-19 outcomes is evolving. Our study aims to investigate hospitalization outcomes of patients with COVID-19 on long term corticosteroids for coexisting conditions while also seeking to compare outcomes between such patients with a history of CLD to analyze the impact on mortality. We conducted a retrospective chart review across our 10-hospital network identifying patients on chronic corticosteroids (Prednisone ≥ 5 mg daily dose or equivalent dose of another steroid, for a duration of 30 days or more) who were hospitalized with COVID-19 from March 1, 2020 to June 30, 2020. Of these patients who met inclusion criteria, patients were then divided into groups based upon their history of CLD. Primary outcomes of the study looked to investigate the hospitalization outcomes of patients with a history of CLD and comorbid conditions requiring chronic corticosteroid use. Secondary outcomes sought to further investigate risk factors for mortality in our study sample. 837 charts were reviewed. 139 patients met inclusion criteria of which 34 patients had a history of CLD. Statistical analysis demonstrated no difference in length of hospital stay but increased ICU admission rate in the CLD group (41.2% vs 23.8%). No statistically significant difference was seen in between the CLD and non-CLD groups in term of complication rates and 28-day mortality. However, chronic corticosteroids patients were found to have higher rates of ICU admission and overall 28-day and ICU mortality in comparison to patients who were not on chronic corticosteroids prior to COVID-19 hospitalization. The larger contributor to COVID-19 severity was likely chronic corticosteroid use rather than CLD and thus chronic corticosteroid use should be limited throughout the COVID-19 pandemic especially in patients with additional speculated risk factors for COVID-19 such as CLD.
format	article
author	Hammad Liaquat Brittney Shupp Samantha Rollins Yecheskel Schneider Ayaz Matin
author_facet	Hammad Liaquat Brittney Shupp Samantha Rollins Yecheskel Schneider Ayaz Matin
author_sort	Hammad Liaquat
title	Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
title_short	Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
title_full	Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
title_fullStr	Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
title_full_unstemmed	Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease
title_sort	comparison of the impact of chronic corticosteroid therapy on critical care outcomes of covid-19 patients with and without history of chronic liver disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/40ee2b3596364b299ad14193c36c6616
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Comparison of the impact of chronic corticosteroid therapy on critical care outcomes of COVID-19 patients with and without history of chronic liver disease

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