RT Journal Article
T1 Influence of chronic use of corticosteroids and calcineurin inhibitors on COVID-19 clinical outcomes: analysis of a nationwide registry.
A1 Calderón-Parra, Jorge
A1 Cuervas-Mons, Valentín
A1 Moreno-Torres, Victor
A1 Rubio-Rivas, Manuel
A1 Blas, Paloma Agudo-de
A1 Pinilla-Llorente, Blanca
A1 Helguera-Amezua, Cristina
A1 Jiménez-García, Nicolás
A1 Pesqueira-Fontan, Paula-María
A1 Méndez-Bailón, Manuel
A1 Artero, Arturo
A1 Gilabert, Noemí
A1 Ibánez-Estéllez, Fátima
A1 Freire-Castro, Santiago-Jesús
A1 Lumbreras-Bermejo, Carlos
A1 Antón-Santos, Juan-Miguel
A1 SEMI-COVID-19 Network. A complete list of the SEMI-COVID-19 Network members is provided in the Appendix, 
K1 COVID-19
K1 autoimmune diseases
K1 immune-mediated inflammatory diseases
K1 immunocompromised host
K1 prognosis factors
K1 solid organ transplantation
AB 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.
YR 2021
FD 2021-12-28
LK http://hdl.handle.net/10668/22268
UL http://hdl.handle.net/10668/22268
LA en
DS RISalud
RD Apr 5, 2025