PT  - JOURNAL ARTICLE
AU  - Leavy, Olivia C.
AU  - Russell, Richard J.
AU  - Harrison, Ewen M.
AU  - Lone, Nazir I.
AU  - Kerr, Steven
AU  - Docherty, Annemarie B.
AU  - Sheikh, Aziz
AU  - Richardson, Matthew
AU  - Elneima, Omer
AU  - Greening, Neil J.
AU  - Harris, Victoria Claire
AU  - Houchen-Wolloff, Linzy
AU  - McAuley, Hamish J.C.
AU  - Saunders, Ruth M.
AU  - Sereno, Marco
AU  - Shikotra, Aarti
AU  - Singapuri, Amisha
AU  - Aul, Raminder
AU  - Beirne, Paul
AU  - Bolton, Charlotte E.
AU  - Brown, Jeremy S.
AU  - Choudhury, Gourab
AU  - Diar Bakerly, Nawar
AU  - Easom, Nicholas
AU  - Echevarria, Carlos
AU  - Fuld, Jonathan
AU  - Hart, Nick
AU  - Hurst, John R.
AU  - Jones, Mark
AU  - Parekh, Dhruv
AU  - Pfeffer, Paul
AU  - Rahman, Najib M.
AU  - Rowland-Jones, Sarah
AU  - Shah, Ajay M.
AU  - Wootton, Dan G.
AU  - Jolley, Caroline
AU  - Thompson, A.A. Roger
AU  - Chalder, Trudie
AU  - Davies, Melanie J.
AU  - De Soyza, Anthony
AU  - Geddes, John R.
AU  - Greenhalf, William
AU  - Heller, Simon
AU  - Howard, Luke
AU  - Jacob, Joseph
AU  - Jenkins, R. Gisli
AU  - Lord, Janet M.
AU  - Man, Will D-C.
AU  - McCann, Gerry P.
AU  - Neubauer, Stefan
AU  - Openshaw, Peter J.M.
AU  - Porter, Joanna
AU  - Rowland, Matthew J.
AU  - Scott, Janet T.
AU  - Semple, Malcolm G.
AU  - Singh, Sally J.
AU  - Thomas, David
AU  - Toshner, Mark
AU  - Lewis, Keir
AU  - Heaney, Liam G.
AU  - Briggs, Andrew
AU  - Zheng, Bang
AU  - Thorpe, Mathew
AU  - Quint, Jennifer K.
AU  - Chalmers, James D.
AU  - Ho, Ling-Pei
AU  - Horsley, Alex
AU  - Marks, Michael
AU  - Poinasamy, Krisnah
AU  - Raman, Betty
AU  - Wain, Louise V.
AU  - Brightling, Christopher E.
AU  - Evans, Rachael A.
ED  - ,
TI  - 1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study
AID  - 10.1183/23120541.00474-2024
DP  - 2024 Sep 01
TA  - ERJ Open Research
PG  - 00474-2024
VI  - 10
IP  - 5
4099  - http://openres.ersjournals.com/content/10/5/00474-2024.short
4100  - http://openres.ersjournals.com/content/10/5/00474-2024.full
SO  - erjor2024 Sep 01; 10
AB  - Background In patients with coronavirus disease 2019 (COVID-19) requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) 1 year after discharge.Methods Adults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies (Post-hospitalisation COVID-19 and the International Severe Acute Respiratory and emerging Infection Consortium). HRQoL, assessed by the EuroQol-Five Dimensions–Five Levels utility index (EQ-5D-5L UI), pre-hospital and 1 year after discharge were compared between those receiving corticosteroids or not after propensity weighting for treatment. Secondary outcomes included patient-reported recovery, physical and mental health status, and measures of organ impairment. Sensitivity analyses were undertaken to account for survival and selection bias.Findings Of the 1888 participants included in the primary analysis, 1149 received corticosteroids. There was no between-group difference in EQ-5D-5L UI at 1 year (mean difference 0.004, 95% CI −0.026–0.034). A similar reduction in EQ-5D-5L UI was seen at 1 year between corticosteroid exposed and nonexposed groups (mean±sd change −0.12±0.22 versus −0.11±0.22). Overall, there were no differences in secondary outcome measures. After sensitivity analyses modelled using a cohort of 109 318 patients admitted to hospital with COVID-19, EQ-5D-5L UI at 1 year remained similar between the two groups.Interpretation Systemic corticosteroids for acute COVID-19 have no impact on the large reduction in HRQoL 1 year after hospital discharge. Treatments to address the persistent reduction in HRQoL are urgently needed.Systemic corticosteroids given for acute COVID-19 do not affect health-related quality of life or other patient-reported outcomes, physical and mental health outcomes, or organ function 1 year after hospital discharge. https://bit.ly/3XR45Ln