Muñoz Gómez, AnaFernández Cruz, AnaLavilla Olleros, CristinaGiner Galvañ, VicenteAusín García, CristinaWikman, PhilipBendala Estrada, Alejandro DavidVargas Núñez, Juan AntonioRubio Rivas, ManuelLaureiro, JaimeFernández Bermúdez, DanielBuonaiuto, Verónica A.Arenas de Larriva, Antonio P.Pascual Pérez, Maria de los ReyesAlcalá Pedrajas, José NicolásLabirua-Iturburu Ruiz, AneHernández Milián, AlmudenaGómez del Mazo, MartaAntequera, BeatrizMella Pérez, CarmenNavas Alcántara, MaríaSoto Delgado, Juan F.Gámez Mancera, Rosa M.Sardiña González, CristinaMeijide Míguez, HéctorRamos-Rincón, José ManuelGómez Huelgas, RicardoOn Behalf of the SEMI-COVID-19 Network2021-11-182021-11-182021-10-13https://hdl.handle.net/2445/181361We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March-July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients.application/pdfengcc-by (c) Muñoz-Gómez, Ana et al., 2021http://creativecommons.org/licenses/by/4.0/COVID-19CortisonaMortalitatCOVID-19CortisoneMortalityinfo:eu-repo/semantics/article2021-11-18info:eu-repo/semantics/openAccess3468280134682801