• Medicina clinica · Jan 2021

    Observational Study

    Association between high-dose steroid therapy, respiratory function, and time to discharge in patients with COVID-19: Cohort study.

    • Alejandro Rodríguez-Molinero, Carlos Pérez-López, César Gálvez-Barrón, Antonio Miñarro, Ezequiel A Rodríguez Gullello, Isabel Collado Pérez, Núria Milà Ràfols, Ernesto E Mónaco, Antonio Hidalgo García, Gemma Añaños Carrasco, Antonio Chamero Pastilla, and en representación del grupo de investigadores para la COVID-19 del Consorci Sanitari de l’Alt Penedès i Garraf (CSAPG).
    • Àrea de Recerca, Consorci Sanitari de l'Alt Penedès i Garraf, Sant Pere de Ribes, Barcelona, España. Electronic address: rodriguez.molinero@gmail.com.
    • Med Clin (Barc). 2021 Jan 8; 156 (1): 7127-12.

    ObjectiveTo analyze whether there is an association between the use glucocorticoids at high doses, and the evolution of saturation/fraction of inspired oxygen (SAFI) or time to discharge, in patients hospitalized with COVID-19.MethodsThis was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia, Spain. As primary outcomes, we studied the evolution of SAFI in the first 48hours of treatment and the time to discharge. The results were compared between patients treated and untreated with glucocorticoids (methylprednisolone 1-2mg/kg/day o dexamethasone 20-40mg/day) through sub-cohort analyses matched for multiple clinical and prognostic factors, as well as through Cox multivariate models adjusted for prognostic factors. The simultaneous use of different treatments for COVID-19 was taken into account, both in sub-cohorts matching and in Cox regression.ResultsThere were 187 patients treated with glucocorticoids; of these, 25 patients could be matched with an equivalent number of control patients. In the analysis of these matched sub-cohorts, no significant difference was observed in time to discharge (log-rank: p=0.291) or the increment in SAFI at 48hours of treatment (glucocorticoides: -0.04; controls: +0.37; p=0.095). Multivariate models using Cox regression showed a significantly longer time to discharge in patients treated with glucocorticoids (hazard ratio: 7.26; 95% IC: 3.30-15.95).ConclusionsWe have not found improvement in respiratory function or time until discharge, associated with the use of glucocorticoids at high doses.Copyright © 2020 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.

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