Calderón-Parra, JorgeCuervas-Mons, ValentínMoreno-Torres, VictorRubio-Rivas, ManuelBlas, Paloma Agudo-dePinilla-Llorente, BlancaHelguera-Amezua, CristinaJiménez-García, NicolásPesqueira-Fontan, Paula-MaríaMéndez-Bailón, ManuelArtero, ArturoGilabert, NoemíIbánez-Estéllez, FátimaFreire-Castro, Santiago-JesúsLumbreras-Bermejo, CarlosAntón-Santos, Juan-MiguelSEMI-COVID-19 Network. A complete list of the SEMI-COVID-19 Network members is provided in the Appendix2023-05-032023-05-032021-12-28http://hdl.handle.net/10668/22268The 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/COVID-19autoimmune diseasesimmune-mediated inflammatory diseasesimmunocompromised hostprognosis factorssolid organ transplantationAdrenal Cortex HormonesCalcineurin InhibitorsHospital MortalityHumansRegistriesRetrospective StudiesSARS-CoV-2COVID-19 Drug Treatmentresearch article34971824open access10.1016/j.ijid.2021.12.3271878-3511PMC8713429http://www.ijidonline.com/article/S1201971221012224/pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713429/pdf