Efficacy Evaluation of Early, Low-Dose, Short-Term Corticosteroids in Adults Hospitalized with Non-Severe COVID-19 Pneumonia: A Retrospective Cohort Study

摘要

ObjectivesThis study aimed to observe the efficacy of corticosteroids in non-severe COVID-19 pneumonia.MethodsA retrospective study based on propensity score matching was designed to explore the effects of corticosteroids. Primary outcomes included the rate of patients who developed severe disease and mortality. Secondary outcomes included duration of fever, virus clearance time, length of hospital stay, and the use of antibiotics.ResultsA total of 475 patients with non-severe COVID-19 pneumonia were enrolled, 55 patients received early, low-dose, and short-term corticosteroids therapy, 420 patients received non-corticosteroids therapy. Compared to the non-corticosteroids group, there was a prolonged duration of fever (median 5 vs 3?days, p ?0.001), virus clearance time (median 18 vs 11?days, p ?0.001), and length of hospital stay (median 23 vs 15?days, p ?0.001) in the corticosteroids group. The percentages of antibiotics therapy (89.1% vs 23.6%, p ?0.001), use of at least two antibiotics?(38.2% vs 12.7%, p =?0.002), and antifungal therapy (7.3% vs 0, p =?0.042) were higher in the corticosteroids group than those in the non-corticosteroids group. Compared to the non-corticosteroids group, more patients developed severe disease (12.7% vs 1.8%, p =?0.028) in the corticosteroids group. There was no?significant?difference between the two groups in mortality (1.8% vs 0, p =?0.315).ConclusionIn adult patients with non-severe COVID-19 pneumonia, early, low-dose, and short-term corticosteroids therapy was associated with worse clinical outcomes.