Potential of outpatient steroid therapy in elderly patients with early COVID-19

Aging Clin Exp Res. 2022 Oct;34(10):2585-2590. doi: 10.1007/s40520-022-02181-1. Epub 2022 Jul 4.

Abstract

Corticosteroids lower mortality in hospitalized patients with COVID-19 pneumonia requiring oxygen support. In this observational retrospective study (September 2020-June 2021), we explored the association between receiving home corticosteroids without oxygen supply and 30-day mortality in hospitalized patients with COVID-19 pneumonia. Among a total of 794 COVID-19 pneumonia patients, 763 were included into the study (males 68%; mean age 65 ±12 years), of whom 197 (26%) received home corticosteroids (mean daily prednisone equivalent-dose 40 mg ± 12 mg; range 10-50 mg; median 50 mg; IQR 25-50 mg; for 4 days). The overall 30-day mortality of the study population was 12%. The risk of death-adjusted for age, comorbidities, administration of remdesivir and respiratory failure severity-was lower (HR 0.405; p = 0.024) in patients receiving home corticosteroids. After stratifying the study population by age categories, home corticosteroids were associated with an adjusted decrease in mortality risk in patients > 77 years (HR 0.346; p = 0.040). Home corticosteroids may lower the 30-day mortality in elderly COVID-19 patients.

Keywords: All-cause mortality; COVID-19; Corticosteroids; Elderly; Outpatient; Pneumonia.

Publication types

  • Observational Study

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • COVID-19 Drug Treatment*
  • Humans
  • Male
  • Outpatients
  • Oxygen
  • Retrospective Studies
  • SARS-CoV-2
  • Steroids

Substances

  • Adrenal Cortex Hormones
  • Oxygen
  • Steroids