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


Sengul A., MUTLU P., Ozdemir O., Satici C., Turan M. O. , Arslan S., ...More

EXPERT REVIEW OF RESPIRATORY MEDICINE, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1080/17476348.2022.2102480
  • Journal Name: EXPERT REVIEW OF RESPIRATORY MEDICINE
  • Journal Indexes: Science Citation Index Expanded, Scopus, Chemical Abstracts Core, EMBASE, MEDLINE
  • Keywords: COVID-19, corticosteroid, hypoxemia, mortality, prognosis, RESPIRATORY-DISTRESS-SYNDROME, DEXAMETHASONE, SEVERITY

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.