Corticosteroid pulses for hospitalized patients with COVID-19. Effects on mortality and in-hospital stay.

https://www.medrxiv.org/content/10.1101/2020.09.30.20204719v1

From 2933 patients in a multicenter retrospective cohort study, 257 fulfilled the inclusion and exclusion criteria. 124 patients were on corticosteroid pulses, and 133 were not. 30,3% (37/122) of patients died in the corticosteroid pulses group and 42,9% (57/133) in the non-exposed cohort. These differences (12,6%) were statically significant (log-rank 4.72, p=0,03). We performed PSM using the exact method. Mortality differences remained in the PSM group (log-rank 5.31, p=0,021) and were still significant after a Cox regression model (HR for corticosteroid pulses 0,561, p= 0,039). There were no significant differences in intensive care admission rate (p=0,173). The hospital stay was longer in the corticosteroid group (p<0,001). This study provides evidence about treatment with corticosteroid pulses in severe COVID-19 that might significantly reduce mortality. Strict inclusion and exclusion criteria with that selection process set a reliable frame to compare mortality in both exposed and non-exposed groups.

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