Outcomes of corticosteroid treatment in critically ill COVID-19 patients

Abstract

Objective: This study aims to examine the impact of low-dose and high-dose corticosteroids on the clinical outcomes and mortality of critically ill patients with COVID-19 in intensive care units. Material and Methods: This study was conducted on 197 confirmed COVID-19 patients who received corticosteroid therapy in the intensive care unit (ICU) between June 1st and December 31st, 2020. Patients were divided into two groups for low- and high-dose corticosteroid therapy. Both groups were compared according to demographic features, comorbid conditions, laboratory parameters, as well as the ordinal scale for clinical improvement (OSCI), hospital mortality, and length of stay in the intensive care unit. Results: A total of 140 patients received low-dose corticosteroids, while 57 patients received high-dose corticosteroid therapy. Our findings revealed a significantly higher median length of stay in the ICU and mortality in the group that received high-dose corticosteroid therapy. We observed a significant reduction in ferritin and D-dimer levels in the group receiving high-dose corticosteroid therapy (p < 0.003, p < 0.012, respectively). Furthermore, OSCIs on admission, day 5, and day 10 after corticosteroid therapy were higher in the group receiving high-dose corticosteroids. Conclusion: The results of this study indicate that high-dose corticosteroid therapy in critically ill patients with COVID-19 is associated with high mortality rates and prolonged intensive care stays.