10.6084/M9.FIGSHARE.C.6233841.V1
Wenjuan Wang
Wenjuan
Wang
King's College London
Luke B Snell
Luke B
Snell
King's College London
Guy's and St Thomas' NHS Foundation Trust
Davide Ferrari
Davide
Ferrari
King's College London
Anna L Goodman
Anna L
Goodman
Guy's and St Thomas' NHS Foundation Trust
Nicholas M Price
Nicholas M
Price
Guy's and St Thomas' NHS Foundation Trust
Charles D Wolfe
Charles D
Wolfe
King's College London
Guy's and St Thomas' NHS Foundation Trust
Vasa Curcin
Vasa
Curcin
King's College London
Guy's and St Thomas' NHS Foundation Trust
Jonathan D Edgeworth
Jonathan D
Edgeworth
King's College London
Guy's and St Thomas' NHS Foundation Trust
Yanzhong Wang
Yanzhong
Wang
King's College London
Guy's and St Thomas' NHS Foundation Trust
Real-world effectiveness of steroids in severe COVID-19: a retrospective cohort study
Abstract Introduction Randomised controlled trials have shown that steroids reduce the risk of dying in patients with severe Coronavirus disease 2019 (COVID-19), whilst many real-world studies have failed to replicate this result. We aim to investigate real-world effectiveness of steroids in severe COVID-19. Methods Clinical, demographic, and viral genome data extracted from electronic patient record (EPR) was analysed from all SARS-CoV-2 RNA positive patients admitted with severe COVID-19, defined by hypoxia at presentation, between March 13th 2020 and May 27th 2021. Steroid treatment was measured by the number of prescription-days with dexamethasone, hydrocortisone, prednisolone or methylprednisolone. The association between steroid > 3 days treatment and disease outcome was explored using multivariable cox proportional hazards models with adjustment for confounders (including age, gender, ethnicity, co-morbidities and SARS-CoV-2 variant). The outcome was in-hospital mortality. Results 1100 severe COVID-19 cases were identified having crude hospital mortality of 15.3%. 793/1100 (72.1%) individuals were treated with steroids and 513/1100 (46.6%) received steroid ≤ 3 days. From the multivariate model, steroid > 3 days was associated with decreased hazard of in-hospital mortality (HR: 0.47 (95% CI: 0.31–0.72)). Conclusion The protective effect of steroid treatment for severe COVID-19 reported in randomised clinical trials was replicated in this retrospective study of a large real-world cohort.
Medicine
Molecular Biology
Biotechnology
Immunology
Mathematical Sciences not elsewhere classified
Cancer
figshare
2022
2022-10-06
2022-10-06
Collection
10.6084/m9.figshare.c.6233841
CC BY 4.0