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Heliyon . Longer duration of high-dose corticosteroids provides benefit for hospitalized COVID-19 patients with high oxygen requirement

tetano

Editor, Senior Moderator
Heliyon


. 2024 Nov 1;10(22):e40059.
doi: 10.1016/j.heliyon.2024.e40059. eCollection 2024 Nov 30. Longer duration of high-dose corticosteroids provides benefit for hospitalized COVID-19 patients with high oxygen requirement

Junping Fan[SUP] 1 [/SUP], Huaiya Xie[SUP] 1 [/SUP], Yaqi Wang[SUP] 1 [/SUP], Siqi Pan[SUP] 1 [/SUP], Tingyu Wang[SUP] 2 3 [/SUP], Chuan Shi[SUP] 1 [/SUP], Xinjie Hui[SUP] 1 [/SUP], Huan Hou[SUP] 1 [/SUP], Xiaoxing Gao[SUP] 1 [/SUP], Wangji Zhou[SUP] 1 [/SUP], Xiangning Liu[SUP] 1 [/SUP], Yunxin Liu[SUP] 1 [/SUP], Jinglan Wang[SUP] 1 [/SUP], Xinlun Tian[SUP] 1 [/SUP]



Affiliations
Abstract

The optimal corticosteroids dose in patients with coronavirus disease 2019 (COVID-19) requiring high oxygen remains unknown. In this retrospective study of patients with COVID-19 requiring high oxygen and receiving corticosteroids, the efficacy, safety, and duration of high-dose treatment were evaluated. The primary outcome was all-cause mortality during follow-up. Safety outcomes included infection, gastrointestinal bleeding, and venous thromboembolic events. 210 patients were included, with 126 in Group A (corticosteroids at a equivalent dose <1 mg/kg/d prednisone), 44 in Group B (corticosteroids at a equivalent dose ≥1 mg/kg/d prednisone for ≤5 days), and 40 in Group C (corticosteroids at a equivalent dose ≥1 mg/kg/d prednisone for >5 days). The all-cause mortality risk was lower in Group C but higher in Group B than in Group A. Safety outcomes did not differ significantly, except for Group C, which had the highest venous thromboembolism rate. Our results suggest that high-dose corticosteroids for a longer course decrease mortality with comparable safety outcome.

Keywords: COVID-19; Corticosteroids; Duration; High oxygen requirement.

 
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