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

Naser Alotaibi 1, Moudhi Alroomi 2, Wael Aboelhassan 3, Soumoud Hussein 4, Rajesh Rajan 5, Noor AlNasrallah 1, Mohammad Al Saleh 6, Maryam Ramadhan 7, Kobalava D Zhanna 8, Jiazhu Pan 9, Haya Malhas 10, Hassan Abdelnaby 11 12, Farah Almutairi 6, Bader Al-Bader 6, Ahmad Alsaber 9, Mohammed Abdullah 2

Affiliations

01 August 2022

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doi: 10.1016/j.amsu.2022.104105

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.

Keywords: Age; COVID-19; Corticosteroids; In-hospital mortality; SARS-COV-2.

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