Corticosteroid Therapy in Severe Cases of Pneumonia Caused by SARS-CoV-2

Salgueiro, Andrea; Baptista, João Pedro; Martins, P.A.F.

doi:10.7759/cureus.33076

Cited by 1 publication

(1 citation statement)

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“…Several studies also provide support for the efficacy of systemic corticosteroid therapy in cases of moderate to severe COVID-19. [13][14][15][16][17] Nevertheless, no prognostic benefit was observed in the population that did not require oxygen administration. [12] Additionally, National Institutes of Health recommend against the use of dexamethasone in patients not requiring hospitalization or supplemental oxygen because patients with COVID-19 who did not require supplemental oxygen had an increased risk of 90-day mortality.…”

Section: This Study Complied With the Principles Of The World Medical...mentioning

confidence: 99%

Efficacy of corticosteroid therapy for oxygen-free coronavirus disease 2019-derived pneumonia

Saito,

Kanai,

Okamoto

et al. 2024

Medicine

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Corticosteroid therapy for oxygen-free coronavirus disease 2019 (COVID-19) is not recommended due to its negative prognostic impact, but the efficacy of corticosteroids when limited to COVID-19 pneumonia is unclear. We aimed to evaluate the efficacy of corticosteroid monotherapy for patients with COVID-19 pneumonia without supplemental oxygen. We retrospectively reviewed patients with oxygen-free COVID-19 pneumonia at our institute between September 2020 and August 2021 and assessed the use of corticosteroids and the timing of initiation. We classified the patients into the following 2 groups: those who were initiated corticosteroids without developing respiratory failure (early steroid group) and those who were not (standard of care [SOC] group). We used inverse probability of treatment weighting (IPW) to balance between the groups. The primary outcome was the incidence of respiratory failure. A total of 144 patient records were reviewed; 63 patients were in the early steroid group and 81 patients were in the SOC group. Of all patients, 14 (22.2%) and 27 (33.3%) patients in the early steroid and SOC group, respectively, required supplemental oxygen (P = .192). After adjusted by the IPW method, 10 (16.0%) and 32 (40.1%) patients in the early steroid and SOC groups, respectively, required supplemental oxygen (P = .004). The logistic regression analysis indicated that early corticosteroid use was significantly associated with a decreased incidence of respiratory failure (odds ratio; 0.17, 95% confidence intervals; 0.06–0.46, P < .001). Corticosteroid monotherapy may suppress the development of exacerbation requiring oxygen supply in patients with oxygen-free COVID-19 pneumonia.

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