Effect of corticosteroids on mortality in hospitalized COVID-19 patients not receiving invasive mechanical ventilation

https://doi.org/10.1002/cpt.2245

Aim of this observational, single centre, prospective study was to assess the association between corticosteroids and hospital mortality in COVID-19 patients who did not receive IMV (OSCI 3-5). 1311 COVID-19 patients admitted to non-intensive care wards were included, and were divided in two cohorts: 1) 480 patients who received corticosteroid therapy 2) 831 patients who did not. The median daily dose was of 8 mg of dexamethasone or equivalent, with a mean therapy duration of 5 (3-9) days. The indication to administer or withhold corticosteroids was given by the treating physician. In-hospital mortality was similar between the two cohorts after adjusting for possible confounders.(ORadj 1.04, 95%CI 0.81-1.34, p=0.74). There was also no difference in Intensive Care Unit (ICU) admission (ORadj 0.81, 95% CI 0.56-1.17, p=0.26). COVID-19 patients with non-invasive mechanical ventilation (NIMV) had a lower risk for ICU admission if they received steroid therapy (ORadj 0.58, 95% CI 0.35-0.94, p=0.03). In conclusion, corticosteroids were overall not associated with a difference in hospital mortality for patients with COVID-19 with OSCI 3-5.

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