About: Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: A retrospective cohort study

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About: Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: A retrospective cohort study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: A retrospective cohort study
Creator	Huang, Ying Yu, Yang Liu, Yihao Liu, Xin Xiao, Han Wu, Jianfeng Guan, Xiangdong Lv, Qingquan Huang, Jianqiang Li, Yanbing Nirantharakumar, Krishnarajah Peng, Sui Si, Xiang Wang, Cuiping Wang, Qiongya Xiao, Haipeng Yang, Daya Yi, Hui Zhou, Qian Zhu, Guochao Cheng, Karkeung Chen, Shuling Liu, Zelong
source	MedRxiv
abstract	Background: Systemic corticosteroids are recommended by some treatment guidelines and used in severe and critical COVID-19 patients, though evidence supporting such use is limited. Methods: From December 26, 2019 to March 15, 2020, 1514 severe and 249 critical hospitalized COVID-19 patients were collected from two medical centers in Wuhan, China. We performed multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (both inverse-probability-of-treatment-weighting (IPTW) and propensity score matching (PSM)) to estimate the association of corticosteroid use with the risk of in-hospital mortality among severe and critical cases. Results: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to no corticosteroid use group, systemic corticosteroid use showed no benefit in reducing in-hospital mortality in both severe cases (HR=1.77, 95% CI: 1.08-2.89, p=0.023), and critical cases (HR=2.07, 95% CI: 1.08-3.98, p=0.028). In the time-varying Cox analysis that with time varying exposure, systemic corticosteroid use still showed no benefit in either population (for severe patients, HR=2.83, 95% CI: 1.72-4.64, p< 0.001; for critical patients, HR=3.02, 95% CI: 1.59-5.73, p=0.001). Baseline characteristics were matched after IPTW and PSM analysis. For severe COVID-19 patients at admission, corticosteroid use was not associated with improved outcome in either the IPTW analysis. For critical COVID-19 patients at admission, results were consistent with former analysis that corticosteroid use did not reduce in-hospital mortality. Conclusions: Corticosteroid use showed no benefit in reducing in-hospital mortality for severe or critical cases. The routine use of systemic corticosteroids among severe and critical COVID-19 patients was not recommended.
has issue date	2020-05-14(xsd:dateTime)
bibo:doi	10.1101/2020.05.11.20097709
has license	medrxiv
sha1sum (hex)	b33f2c1101ee38e656cd832ef6f6be31d61f4e0d
schema:url	https://doi.org/10.1101/2020.05.11.20097709
resource representing a document's title	Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: A retrospective cohort study
resource representing a document's body	covid:b33f2c1101ee38e656cd832ef6f6be31d61f4e0d#body_text
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