The Prognostic Role of Corticosteroid Administration in Hospitalized Patients with Severe COVID-19: A Cross-sectional Study

Abstract

Background and Objective: The COVID-19 pandemic is a recent global issue with no established consensus on treatments. Therefore, the aim of this study was to assess the impact of corticosteroid (CS) pulses on the prognosis of COVID-19 patients admitted to hospitals. Methods: In this retrospective single-center cross-sectional study, we used hospital records of all consecutive patients aged 18 years or older admitted to the hospital from July 23rd to September 23rd, 2021. All patients included in the study had confirmed SARS-CoV-2 infection using polymerase chain reaction (PCR) testing and required hospitalization. Demographic and clinical information, as well as patient outcomes, were collected. Treatment details, including the type(s), cumulative doses, and duration of administered corticosteroids, were also recorded. CS pulse therapy was defined as the daily administration of 24 mg or more of dexamethasone or its equivalents. Results: A total of 500 patients with COVID-19 were included in this study, comprising 122 patients who received CS pulse therapy and 378 patients who did not. A higher mortality rate was observed in patients receiving CS pulse therapy (42.6%) compared to the other group (28%) (p =0.04). Additionally, logistic regression analysis showed an increased mortality risk in patients receiving CS pulse therapy in the crude model (OR=1.54, 95% CI: 1.01-2.27, p <0.01). However, after adjusting for confounding factors, such as mechanical ventilation and ICU admission, the results were reversed (OR=0.21, 95% CI: 0.07-0.62, p <0.01). Conclusion: In the findings of the current study, treatment with CS pulses was shown to significantly enhance recovery in patients with non-severe COVID-19.