|
KMID : 1141520230380020253
|
|
Endocrinology and Metabolism
2023 Volume.38 No. 2 p.253 ~ p.259
|
|
|
Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
|
|
Ku Eu-Jeong
Song Kee-Ho
Kim Kyoung-Min
Seo Gi-Hyeon
Yoo Soon-Jib
|
|
|
Abstract
|
|
|
Background: The severity of coronavirus disease 2019 (COVID-19) among patients with long-term glucocorticoid treatment(LTGT) has not been established. We aimed to evaluate the association between LTGT and COVID-19 prognosis.
Methods: A Korean nationwide cohort database of COVID-19 patients between January 2019 and September 2021 was used. LTGTwas defined as exposure to at least 150 mg of prednisolone (≥5 mg/day and ≥30 days) or equivalent glucocorticoids 180 days before COVID-19 infection. The outcome measurements were mortality, hospitalization, intensive care unit (ICU) admission, length ofstay, and mechanical ventilation.
Results: Among confirmed patients with COVID-19, the LTGT group (n=12,794) was older and had a higher proportion of comorbidities than the control (n=359,013). The LTGT group showed higher in-hospital, 30-day, and 90-day mortality rates than the control (14.0% vs. 2.3%, 5.9% vs. 1.1%, and 9.9% vs. 1.8%, respectively; all P<0.001). Except for the hospitalization rate, the length ofstay, ICU admission, and mechanical ventilation proportions were significantly higher in the LTGT group than in the control (allP<0.001). Overall mortality was higher in the LTGT group than in the control group, and the significance remained in the fully adjusted model (odds ratio [OR], 5.75; 95% confidence interval [CI], 5.31 to 6.23) (adjusted OR, 1.82; 95% CI, 1.67 to 2.00). TheLTGT group showed a higher mortality rate than the control within the same comorbidity score category.
Conclusion: Long-term exposure to glucocorticoids increased the mortality and severity of COVID-19. Prevention and early proactive measures are inevitable in the high-risk LTGT group with many comorbidities.
|
|
|
KEYWORD
|
|
|
COVID-19, Glucocorticoids, Long term adverse effects, Mortality
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
    
|
|