Steroids may reduce risk for death after severe COVID-19 hos
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A longitudinal cohort of patients within a large health care system. Patients included in the analysis were aged 18 years or older and tested for COVID-19 between Jan. 1, 2020, and Dec. 31, 2021. Patients were considered to be hospitalized if they were admitted within 30 days of a positive COVID-19 test. Additionally, patients were only included in the final analysis if they retained at least 365 days of follow-up.

C-reactive protein (CRP) was the unit used to measure inflammation, and patients were only included if they underwent one CRP test “within their initial COVID-19 episode of care,” the researchers wrote. If multiple tests were performed, the highest value was used for the analysis. Researchers also assessed intravenous dexamethasone administered during hospitalization, as well as prescriptions for oral dexamethasone that were prescribed at the hospital or post-discharge.

According to the researchers, higher-than-normal CRP was associated with other markers of severe COVID-19, including the use of supplemental oxygen and intravenous dexamethasone. In addition, increased CRP correlated with an increased mortality risk following recovery from acute COVID-19, with an unadjusted hazard ratio of 1.6 (95% CI, 1.18-2.17) and an adjusted hazard ratio of 1.61 (95% CI, 1.19-2.2). Meanwhile, oral steroid prescription at hospital discharge was associated with a lower risk for death (HR = 0.49; 95% CI, 0.73-0.94).

Hyperinflammation present with severe COVID-19 is associated with an increased mortality risk after hospital discharge. Although suggestive, treatment with anti-inflammatory medications like steroids upon hospital discharge is associated with a decreased post-acute COVID-19 mortality risk.