Corticosteroid Pulses for Hospitalized Patients with COVID‐19: Effects on Mortality

  1. Ivan Cusacovich
  2. Álvaro Aparisi
  3. Miguel Marcos
  4. Cristina Ybarra-Falcón
  5. Carolina Iglesias-Echevarria
  6. Maria Lopez-Veloso
  7. Julio Barraza-Vengoechea
  8. Carlos Dueñas
  9. Santiago Antonio Juarros Martínez
  10. Beatriz Rodríguez-Alonso
  11. José-Ángel Martín-Oterino
  12. Miguel Montero-Baladia
  13. Leticia Moralejo
  14. David Andaluz-Ojeda
  15. Roberto Gonzalez-Fuentes

Reviewed by

Read the full article See related articles

Discuss this preprint

Start a discussion What are Sciety discussions?

Listed in

Log in to save this article

Abstract

Objectives . To assess the influence of corticosteroid pulses on 60‐day mortality in hospitalized patients with severe COVID‐19. Methods . We designed a multicenter retrospective cohort study in three teaching hospitals of Castilla y León, Spain (865,096 people). We selected patients with confirmed COVID‐19 and lung involvement with a pO2/FiO2<300, excluding those exposed to immunosuppressors before or during hospitalization, patients terminally ill at admission, or those who died in the first 24 hours. We performed a propensity score matching (PSM) adjusting covariates that modify the probability of being treated. Then, we used a Cox regression model in the PSM group to consider factors affecting mortality. Results . From 2933 patients, 257 fulfilled the inclusion and exclusion criteria. 124 patients were on corticosteroid pulses (250 mg of methylprednisolone for three days), and 133 were not. 30.3% (37/122) of patients died in the corticosteroid pulse group and 42.9% (57/133) in the nonexposed cohort. These differences (12.6%, 95% CI [8·54‐16.65]) were statically significant (log‐rank 4.72, p = 0, 03). We performed PSM using the exact method. Mortality differences remained in the PSM group (log‐rank 5.31, p = 0.021) and were still significant after a Cox regression model (HR for corticosteroid pulses 0.561; p = 0.039). Conclusions . This study provides evidence about treatment with corticosteroid pulses in severe COVID‐19 that might significantly reduce mortality. Strict inclusion and exclusion criteria with that selection process set a reliable frame to compare mortality in both the exposed and nonexposed groups.

Article activity feed

  1. Version published to 10.1155/2021/6637227
  2. ScreenIT

    SciScore for 10.1101/2020.09.30.20204719: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.09.30.20204719 on medRxiv