학술논문
Corticosteroids for hospitalized patients with mild to critically-ill COVID-19: a multicenter, retrospective, propensity score-matched study
Document Type
article
Author
Satoshi Ikeda; Toshihiro Misumi; Shinyu Izumi; Keita Sakamoto; Naoki Nishimura; Shosei Ro; Koichi Fukunaga; Satoshi Okamori; Natsuo Tachikawa; Nobuyuki Miyata; Masaharu Shinkai; Masahiro Shinoda; Yasunari Miyazaki; Yuki Iijima; Takehiro Izumo; Minoru Inomata; Masaki Okamoto; Tomoyoshi Yamaguchi; Keisuke Iwabuchi; Makoto Masuda; Hiroyuki Takoi; Yoshitaka Oyamada; Shigeki Fujitani; Masamichi Mineshita; Haruyuki Ishii; Atsushi Nakagawa; Nobuhiro Yamaguchi; Makoto Hibino; Kenji Tsushima; Tatsuya Nagai; Satoru Ishikawa; Nobuhisa Ishikawa; Yasuhiro Kondoh; Yoshitaka Yamazaki; Kyoko Gocho; Tomotaka Nishizawa; Akifumi Tsuzuku; Kazuma Yagi; Yuichiro Shindo; Yuriko Takeda; Takeharu Yamanaka; Takashi Ogura
Source
Scientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
Subject
Language
English
ISSN
2045-2322
Abstract
Abstract Corticosteroids use in coronavirus disease 2019 (COVID-19) is controversial, especially in mild to severe patients who do not require invasive/noninvasive ventilation. Moreover, many factors remain unclear regarding the appropriate use of corticosteroids for COVID-19. In this context, this multicenter, retrospective, propensity score–matched study was launched to evaluate the efficacy of systemic corticosteroid administration for hospitalized patients with COVID-19 ranging in the degree of severity from mild to critically-ill disease. This multicenter, retrospective study enrolled consecutive hospitalized COVID-19 patients diagnosed January–April 2020 across 30 institutions in Japan. Clinical outcomes were compared for COVID-19 patients who received or did not receive corticosteroids, after adjusting for propensity scores. The primary endpoint was the odds ratio (OR) for improvement on a 7-point ordinal score on Day 15. Of 1092 COVID-19 patients analyzed, 118 patients were assigned to either the corticosteroid and non-corticosteroid group, after propensity score matching. At baseline, most patients did not require invasive/noninvasive ventilation (85.6% corticosteroid group vs. 89.8% non-corticosteroid group). The odds of improvement in a 7-point ordinal score on Day 15 was significantly lower for the corticosteroid versus non-corticosteroid group (OR, 0.611; 95% confidence interval [CI], 0.388–0.962; p = 0.034). The time to improvement in radiological findings was significantly shorter in the corticosteroid versus non-corticosteroid group (hazard ratio [HR], 1.758; 95% CI, 1.323–2.337; p