Publication date: Oct 16, 2024

Corticosteroids have always been recommended for severe cases of COVID-19. However, the efficacy of treatment with corticosteroids for COVID-19 during the SARS-CoV-2 omicron outbreak in China has not been reported. Clinical data from 406 patients hospitalized for severe/critical COVID-19 from December 2022 to January 2023 at six hospitals in Chongqing were retrospectively analyzed. The primary outcome was all-cause mortality at 28 days in the groups with and without corticosteroids treatment after propensity score matching (PSM). Secondary outcomes were to compare in-hospital mortality and length of survival time with corticosteroids and those without corticosteroids. This study included 406 patients with severe or critical COVID-19, divided into the corticosteroids group (231, 56. 9%) and non-corticosteroids group (175, 43. 1%). After PSM, the use of corticosteroids did not reduce all-cause mortality at 28 days (42. 5% vs. 39. 1%). Univariate analysis showed that corticosteroids were not associated with improved all-cause mortality at 28 days [hazard ratio (HR), 1. 019; 95% confidence interval (CI), 0. 639-1. 623; p = 0. 938]. Multivariate analysis showed similar results (HR, 1. 047; 95% CI, 0. 633-1. 732; p = 0. 858). Among non-survivors, the survival time was significantly larger in those who received corticosteroids compared with the non-corticosteroid users [median 13 (IQR 6. 5-15. 5) vs. 6 (4-11. 25), p = 0. 007]. The use of systemic corticosteroids in severe/critical COVID-19 may provide certain potential survival benefits but does not improve prognosis.

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