Characteristics of our hypoxemic COVID-19 pneumonia patients receiving corticosteroids and mortality-associated factors

Expert Rev Respir Med. 2022 Aug;16(8):953-958. doi: 10.1080/17476348.2022.2102480. Epub 2022 Jul 26.

Abstract

Background: COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia.

Methods: We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors.

Results: Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of ≥ 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality.

Conclusion: Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.

Keywords: COVID-19; corticosteroid; hypoxemia; mortality; prognosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • COVID-19 Drug Treatment*
  • Ferritins
  • Humans
  • Lung Injury*
  • Pneumonia*
  • Retrospective Studies
  • SARS-CoV-2
  • Steroids
  • Troponin

Substances

  • Adrenal Cortex Hormones
  • Steroids
  • Troponin
  • Ferritins