Systemic corticosteroids and mortality in severe and critical COVID-19 patients in Wuhan, China

Background: Systemic corticosteroids are now recommended in many treatment guidelines, though supporting evidence is limited to one randomised controlled clinical trial (RECOVERY). Objective: To identify whether corticosteroids were beneficial to COVID-19 patients. Methods: 1514 severe and 249 critical hospitalized COVID-19 patients from two medical centers in Wuhan, China. Multivariable Cox models, Cox model with time-varying exposure and propensity score analysis (inverse-probability-of-treatment-weighting (IPTW) and propensity score matching (PSM)) to estimate the association of corticosteroid use with risk of in-hospital mortality in severe and critical cases. Results: Corticosteroids were administered in 531 (35.1%) severe and 159 (63.9%) critical patients. Compared to non-corticosteroid group, systemic corticosteroid use was not associated with beneficial effect in reducing in-hospital mortality in both severe cases (HR=1.77, 95% CI: 1.08-2.89, p=0.023), and critical ca...