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Increased Secondary Infection in COVID-19 Patients Treated with Steroids in New York City

Reiichiro Obata1, Tetsuro Maeda1, Dahlia Rizk1

  • 1Department of Medicine, Icahn School of Medicine at Mount Sinai, USA.

Japanese Journal of Infectious Diseases
|January 4, 2021
PubMed

Insights

Steroids did not impact in-hospital mortality for COVID-19 patients. However, steroid use was associated with increased rates of bacterial and fungal infections during hospitalization.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Cytokine release syndrome is a severe complication of coronavirus disease 2019 (COVID-19).
  • Steroids are hypothesized to be effective in managing severe COVID-19 and associated cytokine release syndrome.

Purpose of the Study:

  • To investigate the effect of steroid administration on in-hospital mortality in COVID-19 patients.
  • To evaluate the association between steroid use and the incidence of secondary infections.

Main Methods:

  • Retrospective chart review of 226 hospitalized COVID-19 patients.
  • Patients categorized into steroid and no-steroid groups.
  • Inverse probability weighted analysis to adjust for confounding factors.

Main Results:

  • Steroid group exhibited higher rates of comorbidities and inflammatory markers.
  • Increased incidence of bacterial (25% vs 13.1%) and fungal (12.7% vs 0.7%) infections in the steroid group.
  • Steroid use was not significantly associated with in-hospital mortality (OR 1.02, P=0.94).

Conclusions:

  • Steroid treatment did not alter in-hospital mortality for COVID-19 patients.
  • Steroid administration is linked to a higher risk of developing bacterial and fungal infections.

Keywords:
COVID-19bacterial infectionfungal infectionsteroid

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