• Esther Piniella-Ruiz, María Teresa Bellver-Álvarez, Beatriz Mestre-Gómez, Belén Escolano-Fernández, Sara Vinat-Prado, Rita Cabezas-Olea, María Soledad Acedo-Gutiérrez, Mirian Akasbi-Montalvo, Pablo Ryan-Murua, Ana Bustamante-Fermosel, Nuria Muñoz-Rivas, Carmen Santamaría-García, Virginia Pardo-Guimerá, Mariano Ulla-Anés, Anabel Franco-Moreno, and Juan Torres-Macho.
• Department of Internal Medicine, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain.
• J. Gerontol. A Biol. Sci. Med. Sci. 2021 Jul 13; 76 (8): e127-e132.

BackgroundThe most susceptible population group to critical and fatal coronavirus disease 2019 (COVID-19) is older adults. In severe acute respiratory syndrome coronavirus 2 infection, the host immune response is thought to play a key role in the pathophysiological effects of lung damage. Therefore, corticosteroid therapy could modulate inflammation-mediated pulmonary injury and thereby reduce progression to severe respiratory failure and death. The aim of this study was to analyze the safety and clinical efficacy of corticosteroid therapy in older adults with severe COVID-19 pneumonia.MethodWe reviewed the clinical records of confirmed COVID-19 patients aged 75 years or older admitted to our hospital over a 3-month period (March 1-May 31, 2020). A total of 143 patients were included in the study cohort. From 2 April, 2020, in accordance with World Health Organization guidance on COVID-19, our hospital protocol added corticosteroid for COVID-19 treatment. We compared in-hospital mortality among patients with critical COVID-19 who received corticosteroids therapy and those who did not.ResultsIn total, 88 patients (61.5%) were treated with corticosteroids, and 55 patients (38.4%) were not. Both groups were similar in baseline characteristics. The median age was 85 years (interquartile range: 82-89), and 61.5% (88/143) were male. In-hospital mortality was lower in the corticosteroid group (68.2%) compared with patients in the noncorticosteroid group (81.8%). Treatment with corticosteroids was an independent survival factor (hazard ratio: 0.61; 95% CI: 0.41-0.93; p = .006).ConclusionsIn critically ill older adults with COVID-19 pneumonia, the use of corticosteroid treatment resulted in lower mortality without severe adverse events.© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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