Introduction: The use of steroid therapy in patients within the context of SARS-CoV-2 infection is still a matter of debate. This study aimed to evaluate if potential steroid benefits could be predicted by the ratio of arterial oxygen partial pressure (PaO 2 in mmHg) to fractional inspired oxygen (FiO 2 ) (P/F) in COVID-19 patients at admission. Materials and Methods: Medical records were retrospectively collected from all adult patients admitted because of COVID-19 from 29 January to 31 July 2020. The association of steroid therapy with 28-day all-cause mortality outcome was analysed in a multivariable logistic regression model adjusted for confounding factors. Results: Overall, 511 patients were analysed, of which 39.1% underwent steroid therapy. Steroid treated patients were mostly male, older, and more frequently treated with antiviral drugs and aminoquinolines; the most common comorbidities were hypertension, followed by cardiovascular disease. Overall, 51 patients died within 28-days, and overall 28-days mortality was 19.5% in the cohort of patients exposed to steroids versus 3.9% mortality in unexposed patients ( p < 0.001). Steroid therapy on patients with P/F ratio of 235 mmHg or higher at admission can be considered as detrimental, with an 8% increased probability of death. Conclusions: Steroid therapy is associated with increased 28-day mortality in COVID-19 in patients with mild or no ARDS.
【저자키워드】 COVID-19, ARDS, Steroids, SARS-CoV-2 pneumonia, 【초록키워드】 therapy, Mortality, SARS-COV-2 infection, 28-day mortality, Comorbidity, cardiovascular disease, oxygen, outcome, hypertension, antiviral drug, Probability, male, Patient, death, Mild, Admission, association, detrimental, COVID-19 patient, steroid, medical record, steroid therapy, Older, fractional inspired oxygen, multivariable logistic regression, all-cause mortality, P/F ratio, confounding factors, material, benefit, predicted, collected, evaluate, analysed, treated, adjusted, cohort of patient, COVID-19 in patient, P/F, PaO, patients died, treated patient, 【제목키워드】 steroid, Ratio, PaO,