Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19

Autor: Margaux Lafaurie, Guillaume Martin-Blondel, Pierre Delobel, Nassim Kamar, Sandrine Charpentier, Agnès Sommet, Guillaume Moulis, and the Covid-Clinic-Toul investigators
Přispěvatelé: Service Pharmacologie Clinique [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Pistre, Karine
Rok vydání: 2021
Předmět:
Male
MESH: COVID-19 / drug therapy
[SDV]Life Sciences [q-bio]
MESH: Comorbidity
MESH: Adrenal Cortex Hormones / therapeutic use*
MESH: Hospitalization
Comorbidity
law.invention
Cohort Studies
0302 clinical medicine
Adrenal Cortex Hormones
law
Pharmacology (medical)
030212 general & internal medicine
MESH: Cohort Studies
MESH: Treatment Outcome
MESH: Aged
[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology
MESH: Middle Aged
MESH: Inflammation / drug therapy
Middle Aged
Intensive care unit
MESH: Respiration
Artificial / statistics & numerical data
[SDV] Life Sciences [q-bio]
Hospitalization
Treatment Outcome
[SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
Cohort
Female
Research Article
Cohort study
medicine.medical_specialty
Critical Care
MESH: COVID-19 / mortality
SARS-COV-2
03 medical and health sciences
MESH: Inflammation / etiology
lcsh:RA1190-1270
Internal medicine
medicine
Humans
Mortality
Propensity Score
Aged
lcsh:Toxicology. Poisons
Inflammation
030203 arthritis & rheumatology
Pharmacology
MESH: Humans
business.industry
Pharmacoepidemiology
lcsh:RM1-950
COVID-19
Odds ratio
MESH: Propensity Score
medicine.disease
Respiration
Artificial
MESH: Male
Confidence interval
MESH: Critical Care / statistics & numerical data
COVID-19 Drug Treatment
Pneumonia
lcsh:Therapeutics. Pharmacology
Propensity score matching
[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
Systemic corticosteroids
business
MESH: Female
Zdroj: BMC Pharmacology and Toxicology, Vol 22, Iss 1, Pp 1-6 (2021)
BMC Pharmacology & Toxicology
BMC Pharmacology and Toxicology
BMC Pharmacology and Toxicology, 2021, 22, pp.14. ⟨10.1186/s40360-021-00480-3⟩
ISSN: 2050-6511
DOI: 10.1186/s40360-021-00480-3
Popis: Background The impact of prior exposure to systemic corticosteroids on COVID-19 severity in patients hospitalized for a SARS-CoV-2 pneumonia is not known. The present study was designed to answer to this question. Methods The population study was the Covid-Clinic-Toul cohort which records data about all hospitalized patients with a positive reverse transcriptase polymerase chain reaction for a SARS-CoV-2 infection at Toulouse University hospital, France. Exposure to systemic corticosteroids was assessed at hospital admission. A propensity score (PS) according to corticosteroid exposure was calculated including comorbidities, clinical, radiological and biological variables that impact COVID-19 severity. The primary outcome was composite, including admission to intensive care unit, need of mechanical ventilation and death occurring during the 14 days after hospital admission. Logistic regression models adjusted for the PS (overlap weighting) provided odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results Overall, 253 patients were included in the study. Median age was 64 years, 140 patients (59.6%) were men and 218 (86.2%) had at least one comorbidity. Seventeen patients (6.7%) were exposed to corticosteroids before hospital admission. Chronic inflammatory disease (n = 8) was the most frequent indication. One hundred and twenty patients (47.4%) met the composite outcome. In the crude model, the OR of previous exposure to systemic corticosteroids was 1.64; 95% CI: 0.60–4.44. In the adjusted model, it was 1.09 (95% CI: 0.65–1.83). Conclusion Overall, this study provide some evidences for an absence of an increased risk of unfavorable outcome with previous exposure to corticosteroids in the general setting of patients hospitalized for COVID-19.
Databáze: OpenAIRE
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