Background The impact of prior exposure to systemic corticosteroids on COVID-19 severity in patients hospitalized for a SARS-CoV-2 pneumonia is not known. The present study was designed to answer to this question. Methods The population study was the Covid-Clinic-Toul cohort which records data about all hospitalized patients with a positive reverse transcriptase polymerase chain reaction for a SARS-CoV-2 infection at Toulouse University hospital, France. Exposure to systemic corticosteroids was assessed at hospital admission. A propensity score (PS) according to corticosteroid exposure was calculated including comorbidities, clinical, radiological and biological variables that impact COVID-19 severity. The primary outcome was composite, including admission to intensive care unit, need of mechanical ventilation and death occurring during the 14 days after hospital admission. Logistic regression models adjusted for the PS (overlap weighting) provided odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results Overall, 253 patients were included in the study. Median age was 64 years, 140 patients (59.6%) were men and 218 (86.2%) had at least one comorbidity. Seventeen patients (6.7%) were exposed to corticosteroids before hospital admission. Chronic inflammatory disease ( n = 8) was the most frequent indication. One hundred and twenty patients (47.4%) met the composite outcome. In the crude model, the OR of previous exposure to systemic corticosteroids was 1.64; 95% CI: 0.60–4.44. In the adjusted model, it was 1.09 (95% CI: 0.65–1.83). Conclusion Overall, this study provide some evidences for an absence of an increased risk of unfavorable outcome with previous exposure to corticosteroids in the general setting of patients hospitalized for COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s40360-021-00480-3.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, intensive care unit, pharmacoepidemiology, systemic corticosteroids, 【초록키워드】 Corticosteroid, intensive care, mechanical ventilation, SARS-COV-2 infection, hospital, Comorbidities, COVID-19 severity, Comorbidity, outcome, Cohort, Regression model, Patient, death, France, age, Hospital admission, SARS-CoV-2 pneumonia, university, Admission, Evidence, Odds ratio, chronic, exposure to, Primary outcome, supplementary material, overlap, 95% confidence interval, increased risk, 95% CIs, positive, transcriptase, inflammatory disease, variable, Weighting, men, radiological, polymerase chain, Result, provided, calculated, adjusted, question, absence, hospitalized patient, patients hospitalized, systemic corticosteroid, 【제목키워드】 outcome, Impact, patients hospitalized, systemic corticosteroid,