• José Francisco Pascual Pareja, Rebeca García-Caballero, Llanos Soler Rangel, Miguel Angel Vázquez-Ronda, Silvia Roa Franco, Gema Navarro Jiménez, Miguel Angel Moreno Palanco, Patricia González-Ruano, Ramiro López-Menchaca, Pilar Ruíz-Seco, Bárbara Pagán Muñoz, Alejandro Gómez Gómez, Beatriz Pérez-Monte, Rebeca Fuerte Martínez, Jose Luis Valle López, Arturo Muñoz Blanco, Isabel Rábago Lorite, Patricia Martínez Martín, Gonzalo Serralta San Martín, Jorge Francisco Gómez-Cerezo, and en nombre del grupo de trabajo HUIS-COVID-19.
• Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Universidad Europea de Madrid Villaviciosa de Odón, Madrid, España. Electronic address: josefrancisco.pascual@salud.madrid.org.
• Med Clin (Barc). 2021 Mar 12; 156 (5): 221228221-228.

IntroductionSeveral studies have reported the beneficial effect of glucocorticoids in the treatment of cytokine storm that occurs in patients with severe COVID-19. Various glucocorticoids regimens have been proposed.MethodsRetrospective observational study that includes patients with severe SARS-CoV-2 pneumonia and compares admission to an Intensive Care Unit (ICU) or death during hospitalization in three groups of patients: no glucocorticoids treatment, use of glucocorticoids doses equivalent to less than 250mg of prednisone daily and use of equivalent doses greater than or equal to 250mg of prednisone daily. Multivariate analysis was performed using logistic regression, using the propensity index as a covariant.ResultsOf the 259 patients enrolled in the study, 67 (25.9%) had an unfavorable evolution, dying or requiring ICU admission. Comparative analyzes between different glucocorticoids treatments and the association with ICU admission or death were: glucocorticoids treatment (any dose) versus no glucocorticoids treatment (OR: 0.71 [0.30-1.66]), treatment with glucocorticoids (≥250mg prednisone daily) versus no glucocorticoids treatment (OR: 0.35 [0.11-1.08]) and glucocorticoids treatment (≥250mg prednisone daily) versus patients with glucocorticoids doses <250mg prednisone daily or without glucocorticoids treatment (OR: 0.30 [0.10-0.88]).ConclusionThe results of this study show that patients with severe SARS-CoV-2 pneumonia treated with glucocorticoids pulses with equivalent doses of prednisone greater than or equal to 250mg have a more favorable evolution (less mortality and less admission to ICU).Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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