Outcomes of patients with COVID-19 pneumonia treated with moderate and high dose corticosteroids

Abstract

Introduction: The mortality related to coronavirus disease-2019 (COVID-19) develops due to hyper immune response in most of the patients. The use of corticosteroids (CS) is reported to be effective in decreasing mortality and maintaining a better prognosis but the results of some studies are against the use of CS due to delayed virus clearing, adverse effects, and insignificant effect on clinical course and outcome. We aimed to evaluate the effect of CS use in hospitalized COVID-19 pneumonia patients on clinical course and mortality. Material and Method: Demographic and laboratory data, history for CS treatment, need for oxygen support, duration of hospitalization and/or ICU follow up, and mortality of inpatients with COVID-19 pneumonia treated between 15.03.2020 and 15.06.2021 at Sultan 2. Abdülhamid Han Training and Research Hospital were collected. The whole cases were divided into two groups as CS group (who were given CS) and the control group (who did not receive CS). All parameters were compared between the two groups. Results: A total of 185 patients (122 CS group and, 63 control group) were included in the study. The patients in the CS group were younger than the controls (median age was 63 (30-91) years and 71 (34-91) years respectively, p<0.001). In the CS group compared to controls, the number of cases followed in ICU and intubated was lower (55 [45.1%] cases vs. 53 [84.1%] cases, p<0.001 and 40 [32.8%] cases vs. 53 [84.1%] cases, p<0.001, respectively) but, the time for ICU and hospital stay was longer (13 [1-32] days vs.6 [1-29] days, p<0.001 and 11 [5-44] days vs. 9 [4-35]days, p=0.005, respectively). The number of cases who died was less in the CS group compared to controls significantly (35 [28.7%] cases vs. 53 [84.1%] cases respectively, p<0.001). Conclusion: CS treatment may be related to better prognosis and less mortality in COVID-19 pneumonia inpatients although it may prolong the time for ICU follow up and hospitalization.