Outpatient glucocorticoid use and COVID-19 outcomes: a population-based study.

Autor: Rodríguez-Fernández A; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain., Visos-Varela I; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain., Zapata-Cachafeiro M; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain. maruxa.zapata@usc.es.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain. maruxa.zapata@usc.es.; Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain. maruxa.zapata@usc.es., Pintos-Rodríguez S; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain., García-Álvarez RM; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain.; Service of Preventive Medicine and Public Health. Clinic Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Herdeiro TM; Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal., Piñeiro-Lamas M; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain., Figueiras A; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain., Salgado-Barreira Á; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Rúa de San Francisco, S/N, 15782, Santiago de Compostela (A Coruña), Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
Jazyk: angličtina
Zdroj: Inflammopharmacology [Inflammopharmacology] 2024 Aug; Vol. 32 (4), pp. 2305-2315. Date of Electronic Publication: 2024 May 02.
DOI: 10.1007/s10787-024-01474-3
Abstrakt: Introduction: Owing to controversy information surrounds effect of glucocorticoids on the evolution of COVID-19, we evaluate the effects of outpatient glucocorticoid use on the severity and progression of COVID-19 and risk of infection and analyse the effect of window of exposure and dose.
Methods: We conducted a population-based case - control study, involving 4 substudies: (i) Hospitalisation; (ii) Mortality, using subjects hospitalised with a PCR + as cases and subjects without a PCR + as controls; (iii) Progression, including subjects with a PCR + (hospitalised versus non-hospitalised); and (iv) Susceptibility, with all subjects with a PCR + and subjects without a PCR + . Adjusted odds ratios (ORa) and their 95% confidence intervals (95% CI) were calculated.
Results: The outpatient glucocorticoid use was associated with an increased risk of hospitalisation (aOR 1.79; 95% CI 1.56-2.05), mortality (aOR 2.30; 95% CI 1.68-3.15), progression (aOR 1.69; 95% CI 1.43-2.00) and susceptibility (aOR 1.29, 95% CI 1.19-1.41). Furthermore, the effects was observed to be greater at higher doses and the closer that drug use approached the outcome date, with an almost fourfold increase in mortality among users in the previous month (aOR 3.85; 95% CI 2.63-5.62).
Conclusions: According to the results of this real-world data study, outpatient glucocorticoid use should be considered in making decisions about intrahospital treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
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