Impact of corticosteroids use on midterm sequelae in survivors of COVID‐19 admitted to hospital: A prospective cohort study

Author:

Gault Nathalie12,Bachelet Delphine12,Laouénan Cédric123,Borie Raphaël4,Cracowski Claire5,Poissy Julien6,Faure Karine7,Lainé Fabrice8,Lefèvre Benjamin910,Isnard Margaux11,Patrier Juliette12,Launay Odile13,Costagliola Dominique14,Ghosn Jade315ORCID,Bouadma Lila312,

Affiliation:

1. INSERM, Centre d'Investigations cliniques‐Epidémiologie Clinique 1425 Hôpital Bichat Paris France

2. Département Epidémiologie Biostatistiques et Recherche Clinique AP‐HP.Nord Université Paris Cité, Hôpital Bichat Paris France

3. INSERM, IAME UMR 1137 Université Paris Cité Paris France

4. AP‐HP, Service de Pneumologie, Hôpital Bichat Paris France

5. INSERM CIC1406, Clinical Pharmacology Department Grenoble Alpes University Hospital Grenoble France

6. Université de Lille, Inserm U1285, CHU Lille, Pôle de réanimation, CNRS, UMR 8576—UGSF—Unité de Glycobiologie Structurale et Fonctionnelle Lille France

7. Service de Maladies Infectieuses et Tropicales, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019—UMR 9017—CIIL—Center for Infection and Immunity of Lille Université de Lille Lille France

8. CHU Rennes, INSERM CIC 1414 Rennes France

9. CHRU Nancy, Infectious and Tropical Diseases Université de Lorraine Nancy France

10. EA 4360 Apemac, Université de Lorraine Nancy France

11. Centre Hospitalier Métropole Savoie, service de Réanimation Polyvalente Adulte Chambery France

12. Service de réanimation médicale et des maladies infectieuses, Hôpital Bichat AP‐HP.Nord Université Paris Cité Paris France

13. INSERM, CIC Vaccinologie, Hôpital Cochin Paris France

14. INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Sorbonne Université Paris France

15. Service de Maladies Infectieuses et Tropicales Hôpital Bichat, AP‐HP.Nord Université Paris Cité Paris France

Abstract

AbstractAn understanding of the midterm sequelae in COVID‐19 and their association with corticosteroids use are needed. Between March and July 2020, we evaluated 1227 survivors of COVID‐19, 3 months posthospitalization, of whom 213 had received corticosteroids within 7 days of admission. Main outcome was any midterm sequelae (oxygen therapy, shortness of breath, one major clinical sign, two minor clinical signs or three minor symptoms). Association between corticosteroids use and midterm sequelae was assessed using inverse propensity‐score weighting models. Our sample included 753 (61%) male patients, and 512 (42%) were older than 65 years. We found a higher rate of sequelae among users than nonusers of corticosteroids (42% vs. 35%, odds ratio [OR] 1.40 [1.16–1.69]). Midterm sequelae were more frequent in users of low‐dose corticosteroids than nonusers (64% vs. 51%, OR 1.60 [1.10–2.32]), whereas no association between higher doses (≥20 mg/day equivalent of dexamethasone) and sequelae was evidenced (OR 0.95 [0.56–1.61]). Higher risk of sequelae with corticosteroids use was observed among subjects with propensity score below the 90th percentile. Our study suggest that corticosteroids use during hospitalization for COVID‐19 is associated with higher risk of midterm sequelae.

Funder

Ministère des Affaires Sociales et de la Santé

Publisher

Wiley

Subject

Infectious Diseases,Virology

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