Impact of corticosteroid doses on prognosis of severe and critical COVID-19 patients with Omicron variant infection: a propensity score matching study

{ 'indexed': {'date-parts': [[2024, 9, 22]], 'date-time': '2024-09-22T04:16:31Z', 'timestamp': 1726978591238}, 'reference-count': 31, 'publisher': 'Springer Science and Business Media LLC', 'issue': '5', 'license': [ { 'start': { 'date-parts': [[2024, 8, 9]], 'date-time': '2024-08-09T00:00:00Z', 'timestamp': 1723161600000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2024, 8, 9]], 'date-time': '2024-08-09T00:00:00Z', 'timestamp': 1723161600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [ { 'name': 'National High Level Hospital Clinical Research Funding', 'award': ['2022-NHLHCRF-LX-01-01']}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2024, 10]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>There is lack of research on corticosteroid use for severe and ' 'critical COVID-19 patients with Omicron variant infection.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This multi-center retrospective cohort study involved 1167 patients ' 'from 59 ICUs across the mainland of China diagnosed with severe or critical SARS-CoV-2 ' 'Omicron variant infection between November 1, 2022, and February 11, 2023. Patients were ' 'segregated into two groups based on their corticosteroid treatment—usual dose (equivalent ' 'prednisone dose 30–50\xa0mg/day) and higher dose (equivalent prednisone dose\u2009&gt;\u2009' '50\xa0mg/day). The primary outcome was 28-day ICU mortality. Propensity score matching was ' 'used to compare outcomes between cohorts.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>After propensity score matching, 520 patients in the usual dose ' 'corticosteroid group and 260 patients in the higher dose corticosteroid group were included ' 'in the analysis, respectively. The mortality was significantly higher in the higher dose ' 'corticosteroid group (67.3%, 175/260) compared to the usual dose group (56.0%, 291/520). ' 'Logistic regression showed that higher doses of corticosteroids were significantly associated ' 'with increased mortality at 28-day (OR\u2009=\u20091.62,95% CI 1.19–2.21, ' '<jats:italic>p</jats:italic>\u2009=\u20090.002) and mortality in ICU stay (OR\u2009=\u2009' '1.66,95% CI 1.21–2.28, <jats:italic>p</jats:italic>\u2009=\u20090.002). Different types of ' 'corticosteroids did not affect the effect.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusions</jats:title>\n' ' <jats:p>The study suggests that higher-dose corticosteroids may lead to a ' 'poorer prognosis for severe and critical COVID-19 patients with Omicron variant infection in ' 'the ICU. Further research is needed to determine the appropriate corticosteroid dosage for ' 'these patients.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1007/s10787-024-01520-0', 'type': 'journal-article', 'created': {'date-parts': [[2024, 8, 9]], 'date-time': '2024-08-09T09:12:22Z', 'timestamp': 1723194742000}, 'page': '3347-3356', 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Impact of corticosteroid doses on prognosis of severe and critical COVID-19 patients with ' 'Omicron variant infection: a propensity score matching study', 'prefix': '10.1007', 'volume': '32', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-1066-4850', 'authenticated-orcid': False, 'given': 'Shiyao', 'family': 'Wang', 'sequence': 'first', 'affiliation': []}, {'given': 'Ziying', 'family': 'Chen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xinran', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xiaojing', 'family': 'Wu', 'sequence': 'additional', 'affiliation': []}, {'given': 'Yuqiong', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Qi', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Linna', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xiaoyang', 'family': 'Cui', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ying', 'family': 'Cai', 'sequence': 'additional', 'affiliation': []}, {'given': 'Xu', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jingen', 'family': 'Xia', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sichao', 'family': 'Gu', 'sequence': 'additional', 'affiliation': []}, {'given': 'Min', 'family': 'Li', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-0021-0270', 'authenticated-orcid': False, 'given': 'Qingyuan', 'family': 'Zhan', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2024, 8, 9]]}, 'reference': [ { 'issue': '13', 'key': '1520_CR1', 'doi-asserted-by': 'publisher', 'first-page': '1317', 'DOI': '10.1001/jama.2020.17022', 'volume': '324', 'author': 'DC Angus', 'year': '2020', 'unstructured': 'Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A et al (2020) ' 'Effect of hydrocortisone on mortality and organ support in patients with ' 'severe COVID-19: the remap-cap covid-19 corticosteroid domain randomized ' 'clinical trial. 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This study was performed in ' 'accordance with the Declaration of Helsinki.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval'}}, { 'value': '\xa0The authors have no relevant financial or non-financial interests to ' 'disclose.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of interests'}}, { 'value': 'Written informed consent was waived.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent to participate'}}, { 'value': 'Not applicable.', 'order': 5, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent to publish'}}]}