In-hospital mortality in SARS-CoV-2 stratified by the use of corticosteroid

Alotaibi, Naser and Alroomi, Moudhi and Aboelhassan, Wael and Hussein, Soumoud and Rajan, Rajesh and AlNasrallah, Noor and Al Saleh, Mohammad and Ramadhan, Maryam and Zhanna, Kobalava D. and Pan, Jiazhu and Malhas, Haya and Abdelnaby, Hassan and Almutairi, Farah and Al-Bader, Bader and Alsaber, Ahmad and Abdullah, Mohammed (2022) In-hospital mortality in SARS-CoV-2 stratified by the use of corticosteroid. Annals of Medicine and Surgery, 80. 104105. ISSN 2049-0801 (https://doi.org/10.1016/j.amsu.2022.104105)

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Abstract

Objective: To investigate COVID-19 related mоrtаlity according to the use of corticosteroid therapy. Design: Retrospective cohort study. Setting: Two tertiary hospitals in Kuwait. Participants: Overall, 962 patients with confirmed SARS-CoV-2 infection, were stratified according to whether they were treated with corticosteroids (dexamethasone or methylprednisolone). The mean age of the patients was 50.2 ± 15.9 years and 344/962 (35.9%) were female. Main outcome measures: In-hospital mortality and cumulative all-cause mortality. Results: Compared to non-corticosteroid therapy patients, corticosteroid therapy patients had a higher prevalence of hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease, and chronic kidney disease; a longer hospital stay (median [IQR]: 17.0 [5.0–57.3] days vs 14.0 [2.0–50.2] days); and a higher in-hospital mortality (51/199 [25.6%] vs 36/763 [4.7%]). Logistic regression analysis showed a higher in-hospital mortality in the corticosteroid group (adjusted odds ratio [aOR]: 4.57, 95% confidence interval [CI]: 2.64–8.02, p < 0.001). Cox proportional hazards regression showed that corticosteroid use was a significant predictor of mortality (hazard ratio [HR]: 3.96, p < 0.001). Conclusions: In-hospital mortality in patients with SARS-CoV-2 on corticosteroid therapy was 4.6 times higher than in those without corticosteroid therapy.

ORCID iDs

Alotaibi, Naser, Alroomi, Moudhi, Aboelhassan, Wael, Hussein, Soumoud, Rajan, Rajesh, AlNasrallah, Noor, Al Saleh, Mohammad, Ramadhan, Maryam, Zhanna, Kobalava D., Pan, Jiazhu ORCID logoORCID: https://orcid.org/0000-0001-7346-2052, Malhas, Haya, Abdelnaby, Hassan, Almutairi, Farah, Al-Bader, Bader, Alsaber, Ahmad ORCID logoORCID: https://orcid.org/0000-0001-9478-0404 and Abdullah, Mohammed;
CORE (COnnecting REpositories)