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Corticosteroids Treatment of Patients with Coronavirus Disease 2019: A Propensity Score Matching Study
Meng-Yuan Liang1, Ping Chen1, Miao He1
1Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Insights
Corticosteroids treatment for Coronavirus disease 2019 (COVID-19) showed no significant impact on viral shedding duration or mortality after adjusting for patient characteristics. This study clarifies the controversial role of these steroids in COVID-19 patient outcomes.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- The use of corticosteroids in treating Coronavirus disease 2019 (COVID-19) remains a subject of debate.
- Understanding the precise impact of corticosteroids on COVID-19 patient outcomes is crucial for clinical decision-making.
Purpose of the Study:
- To investigate the effects of adjuvant corticosteroid therapy on the outcomes of patients diagnosed with COVID-19.
- To clarify the controversial role of corticosteroids in managing COVID-19.
Main Methods:
- A cohort of 966 COVID-19 patients was analyzed.
- Propensity Score Matching was employed to balance baseline characteristics between the corticosteroid (n=289) and non-corticosteroid (n=677) groups.
- Outcomes including viral shedding duration, in-hospital mortality, and 28-day mortality were assessed.
Main Results:
- Unadjusted analysis suggested higher mechanical ventilation rates and mortality in the corticosteroid group for severe/critical patients.
- Unadjusted analysis indicated longer viral shedding in the non-corticosteroid group for general/mild patients.
- After Propensity Score Matching, corticosteroid use demonstrated no significant effect on viral shedding duration, in-hospital mortality, or 28-day mortality.
Conclusions:
- Adjuvant corticosteroid therapy does not appear to significantly influence viral shedding duration or mortality in COVID-19 patients when adjusted for confounding factors.
- The findings suggest a neutral effect of corticosteroids on key COVID-19 outcomes, challenging previous controversial observations.
Abstract:
The role of corticosteroids in the treatment of Coronavirus disease 2019 (COVID-19) is controversial. In the present study, we evaluated the effects of adjuvant corticosteroids treatment on the outcome of patients with COVID-19 (n=966), using Propensity Score Matching to adjust for potential differences between the corticosteroids group (n=289) and the non-corticosteroids group (n=677). Analysis of data without adjusting differences in baseline characteristics indicated that the proportion of mechanical ventilation and the mortality was higher in the corticosteroids treatment group in total or severe/critical patients. The duration of viral shedding was longer in the non-corticosteroids treatment group in total or general/mild patients. After adjusting the difference between the corticosteroids and non-corticosteroids treatment group, the analysis revealed that the use of corticosteroids had no effect on the duration of viral shedding, in-hospital mortality or 28-day mortality.
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