Muñoz-Gómez, AnaFernández-Cruz, AnaLavilla-Olleros, CristinaGiner-Galvañ, VicenteAusín-García, CristinaWikman, PhilipBendala-Estrada, Alejandro DVargas, Juan ARubio-Rivas, ManuelLaureiro, JaimeFernández-Bermúdez, DanielBuonaiuto, Verónica AArenas de Larriva, Antonio PPascual-Pérez, María de Los ReyesAlcalá-Pedrajas, José NLabirua-Iturburu Ruiz, AneHernández-Milián, AlmudenaGómez Del Mazo, MartaAntequera, BeatrizMella-Pérez, CarmenNavas-Alcántara, María de la SierraSoto-Delgado, Juan FGámez-Mancera, Rosa MSardiña-González, CristinaMeijide-Míguez, HéctorRamos-Rincón, José MGómez-Huelgas, RicardoOn Behalf Of The Semi-Covid-Network,2025-01-072025-01-072021-10-132077-0383https://hdl.handle.net/10668/25893We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March-July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/COVID-19SARS-CoV-2corticosteroidsmortalityresearch article34682801open access10.3390/jcm10204678PMC8540860https://www.mdpi.com/2077-0383/10/20/4678/pdf?version=1634626102https://pmc.ncbi.nlm.nih.gov/articles/PMC8540860/pdf