Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19
Abstract 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 d...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Pharmacology and Toxicology |
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| Online Access: | https://doi.org/10.1186/s40360-021-00480-3 |
| _version_ | 1818870739645759488 |
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| author | Margaux Lafaurie Guillaume Martin-Blondel Pierre Delobel Nassim Kamar Sandrine Charpentier Agnès Sommet Guillaume Moulis and the Covid-Clinic-Toul investigators |
| author_facet | Margaux Lafaurie Guillaume Martin-Blondel Pierre Delobel Nassim Kamar Sandrine Charpentier Agnès Sommet Guillaume Moulis and the Covid-Clinic-Toul investigators |
| author_sort | Margaux Lafaurie |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T12:11:49Z |
| format | Article |
| id | doaj.art-83266ec36c344eedaa67577dabc9f8d2 |
| institution | Directory Open Access Journal |
| issn | 2050-6511 |
| language | English |
| last_indexed | 2024-12-19T12:11:49Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pharmacology and Toxicology |
| spelling | doaj.art-83266ec36c344eedaa67577dabc9f8d22022-12-21T20:22:10ZengBMCBMC Pharmacology and Toxicology2050-65112021-03-012211610.1186/s40360-021-00480-3Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19Margaux Lafaurie0Guillaume Martin-Blondel1Pierre Delobel2Nassim Kamar3Sandrine Charpentier4Agnès Sommet5Guillaume Moulis6and the Covid-Clinic-Toul investigatorsService de Pharmacologie Médicale, Centre Hospitalier Universitaire de Toulouse, Faculté de MédecineService des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Toulouse-PurpanService des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Toulouse-PurpanService de Néphrologie et Transplantation d’Organes, Centre Hospitalier Universitaire de Toulouse-RangueilService des Urgences, Centre Hospitalier Universitaire de ToulouseService de Pharmacologie Médicale, Centre Hospitalier Universitaire de Toulouse, Faculté de MédecineCentre d’investigation clinique 1436, axe pharmacoépidémiologie, Centre Hospitalier Universitaire de Toulouse-PurpanAbstract 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.https://doi.org/10.1186/s40360-021-00480-3SARS-COV-2COVID-19Systemic corticosteroidsMortalityIntensive care unitPharmacoepidemiology |
| spellingShingle | Margaux Lafaurie Guillaume Martin-Blondel Pierre Delobel Nassim Kamar Sandrine Charpentier Agnès Sommet Guillaume Moulis and the Covid-Clinic-Toul investigators Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 BMC Pharmacology and Toxicology SARS-COV-2 COVID-19 Systemic corticosteroids Mortality Intensive care unit Pharmacoepidemiology |
| title | Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 |
| title_full | Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 |
| title_fullStr | Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 |
| title_full_unstemmed | Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 |
| title_short | Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19 |
| title_sort | impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for covid 19 |
| topic | SARS-COV-2 COVID-19 Systemic corticosteroids Mortality Intensive care unit Pharmacoepidemiology |
| url | https://doi.org/10.1186/s40360-021-00480-3 |
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