%0 Journal Article
%A Calderón-Parra, Jorge
%A Cuervas-Mons, Valentín
%A Moreno-Torres, Victor
%A Rubio-Rivas, Manuel
%A Blas, Paloma Agudo-de
%A Pinilla-Llorente, Blanca
%A Helguera-Amezua, Cristina
%A Jiménez-García, Nicolás
%A Pesqueira-Fontan, Paula-María
%A Méndez-Bailón, Manuel
%A Artero, Arturo
%A Gilabert, Noemí
%A Ibánez-Estéllez, Fátima
%A Freire-Castro, Santiago-Jesús
%A Lumbreras-Bermejo, Carlos
%A Antón-Santos, Juan-Miguel
%A SEMI-COVID-19 Network. A complete list of the SEMI-COVID-19 Network members is provided in the Appendix
%T Influence of chronic use of corticosteroids and calcineurin inhibitors on COVID-19 clinical outcomes: analysis of a nationwide registry.
%D 2021
%U http://hdl.handle.net/10668/22268
%X The aim of this study was to analyze whether subgroups of immunosuppressive (IS) medications conferred different outcomes in COVID-19. The study involved a multicenter retrospective cohort of consecutive immunosuppressed patients (ISPs) hospitalized with COVID-19 from March to July, 2020. The primary outcome was in-hospital mortality. A propensity score-matched (PSM) model comparing ISP and non-ISP was planned, as well as specific PSM models comparing individual IS medications associated with mortality. Out of 16 647 patients, 868 (5.2%) were on chronic IS therapy prior to admission and were considered ISPs. In the PSM model, ISPs had greater in-hospital mortality (OR 1.25, 95% CI 0.99-1.62), which was related to a worse outcome associated with chronic corticoids (OR 1.89, 95% CI 1.43-2.49). Other IS drugs had no repercussions with regard to mortality risk (including calcineurin inhibitors (CNI); OR 1.19, 95% CI 0.65-2.20). In the pre-planned specific PSM model involving patients on chronic IS treatment before admission, corticosteroids were associated with an increased risk of mortality (OR 2.34, 95% CI 1.43-3.82). Chronic IS therapies comprise a heterogeneous group of drugs with different risk profiles for severe COVID-19 and death. Chronic systemic corticosteroid therapy is associated with increased mortality. On the contrary, CNI and other IS treatments prior to admission do not seem to convey different outcomes.
%K COVID-19
%K autoimmune diseases
%K immune-mediated inflammatory diseases
%K immunocompromised host
%K prognosis factors
%K solid organ transplantation
%~