RT Journal Article
SR Electronic
T1 1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00474-2024
DO 10.1183/23120541.00474-2024
VO 10
IS 5
A1 Leavy, Olivia C.
A1 Russell, Richard J.
A1 Harrison, Ewen M.
A1 Lone, Nazir I.
A1 Kerr, Steven
A1 Docherty, Annemarie B.
A1 Sheikh, Aziz
A1 Richardson, Matthew
A1 Elneima, Omer
A1 Greening, Neil J.
A1 Harris, Victoria Claire
A1 Houchen-Wolloff, Linzy
A1 McAuley, Hamish J.C.
A1 Saunders, Ruth M.
A1 Sereno, Marco
A1 Shikotra, Aarti
A1 Singapuri, Amisha
A1 Aul, Raminder
A1 Beirne, Paul
A1 Bolton, Charlotte E.
A1 Brown, Jeremy S.
A1 Choudhury, Gourab
A1 Diar Bakerly, Nawar
A1 Easom, Nicholas
A1 Echevarria, Carlos
A1 Fuld, Jonathan
A1 Hart, Nick
A1 Hurst, John R.
A1 Jones, Mark
A1 Parekh, Dhruv
A1 Pfeffer, Paul
A1 Rahman, Najib M.
A1 Rowland-Jones, Sarah
A1 Shah, Ajay M.
A1 Wootton, Dan G.
A1 Jolley, Caroline
A1 Thompson, A.A. Roger
A1 Chalder, Trudie
A1 Davies, Melanie J.
A1 De Soyza, Anthony
A1 Geddes, John R.
A1 Greenhalf, William
A1 Heller, Simon
A1 Howard, Luke
A1 Jacob, Joseph
A1 Jenkins, R. Gisli
A1 Lord, Janet M.
A1 Man, Will D-C.
A1 McCann, Gerry P.
A1 Neubauer, Stefan
A1 Openshaw, Peter J.M.
A1 Porter, Joanna
A1 Rowland, Matthew J.
A1 Scott, Janet T.
A1 Semple, Malcolm G.
A1 Singh, Sally J.
A1 Thomas, David
A1 Toshner, Mark
A1 Lewis, Keir
A1 Heaney, Liam G.
A1 Briggs, Andrew
A1 Zheng, Bang
A1 Thorpe, Mathew
A1 Quint, Jennifer K.
A1 Chalmers, James D.
A1 Ho, Ling-Pei
A1 Horsley, Alex
A1 Marks, Michael
A1 Poinasamy, Krisnah
A1 Raman, Betty
A1 Wain, Louise V.
A1 Brightling, Christopher E.
A1 Evans, Rachael A.
A1 
YR 2024
UL http://openres.ersjournals.com/content/10/5/00474-2024.abstract
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