RT Journal Article
T1 Corticosteroid treatment and mortality in mechanically ventilated COVID-19-associated acute respiratory distress syndrome (ARDS) patients: a multicentre cohort study
A1 Moreno, Gerard
A1 Carbonell, Raquel
A1 Martin-Loeches, Ignacio
A1 Sole-Violan, Jordi
A1 Fraga, Eudald Correig, I
A1 Gomez, Josep
A1 Ruiz-Botella, Manuel
A1 Trefler, Sandra
A1 Bodi, Maria
A1 Paya, Josefa Murcia
A1 Diaz, Emili
A1 Vidal-Cortes, Pablo
A1 Papiol, Elisabeth
A1 Albaya Moreno, Antonio
A1 Sancho Chinesta, Susana
A1 Socias Crespi, Lorenzo
A1 Del Carmen Lorente, Maria
A1 Loza Vazquez, Ana
A1 Vara Arlanzon, Rebeca
A1 Teresa Recio, Maria
A1 Carlos Ballesteros, Juan
A1 Ferrer, Ricard
A1 Fernandez Rey, Elisabeth
A1 Restrepo, Marcos, I
A1 Estella, Angel
A1 Margarit Ribas, Antonio
A1 Guasch, Neus
A1 Reyes, Luis F.
A1 Marin-Corral, Judith
A1 Rodriguez, Alejandro
A1 COVID-19 SEMICYUC Working Grp, 
K1 Corticosteroids
K1 COVID-19-associated acute respiratory distress syndrome
K1 Intensive care unit
K1 Mortality
K1 Invasive mechanical ventilation
K1 Covid-19
AB Background Some unanswered questions persist regarding the effectiveness of corticosteroids for severe coronavirus disease 2019 (COVID-19) patients. We aimed to assess the clinical effect of corticosteroids on intensive care unit (ICU) mortality among mechanically ventilated COVID-19-associated acute respiratory distress syndrome (ARDS) patients. Methods This was a retrospective study of prospectively collected data conducted in 70 ICUs (68 Spanish, one Andorran, one Irish), including mechanically ventilated COVID-19-associated ARDS patients admitted between February 6 and September 20, 2020. Individuals who received corticosteroids for refractory shock were excluded. Patients exposed to corticosteroids at admission were matched with patients without corticosteroids through propensity score matching. Primary outcome was all-cause ICU mortality. Secondary outcomes were to compare in-hospital mortality, ventilator-free days at 28 days, respiratory superinfection and length of stay between patients with corticosteroids and those without corticosteroids. We performed survival analysis accounting for competing risks and subgroup sensitivity analysis. Results We included 1835 mechanically ventilated COVID-19-associated ARDS, of whom 1117 (60.9%) received corticosteroids. After propensity score matching, ICU mortality did not differ between patients treated with corticosteroids and untreated patients (33.8% vs. 30.9%; p = 0.28). In survival analysis, corticosteroid treatment at ICU admission was associated with short-term survival benefit (HR 0.53; 95% CI 0.39-0.72), although beyond the 17th day of admission, this effect switched and there was an increased ICU mortality (long-term HR 1.68; 95% CI 1.16-2.45). The sensitivity analysis reinforced the results. Subgroups of age
PB Springer
SN 2110-5820
YR 2021
FD 2021-11-26
LK https://hdl.handle.net/10668/25114
UL https://hdl.handle.net/10668/25114
LA en
DS RISalud
RD Apr 8, 2025