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1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study.
Leavy, Olivia C; Russell, Richard J; Harrison, Ewen M; Lone, Nazir I; Kerr, Steven; Docherty, Annemarie B; Sheikh, Aziz; Richardson, Matthew; Elneima, Omer; Greening, Neil J; Harris, Victoria Claire; Houchen-Wolloff, Linzy; McAuley, Hamish J C; Saunders, Ruth M; Sereno, Marco; Shikotra, Aarti; Singapuri, Amisha; Aul, Raminder; Beirne, Paul; Bolton, Charlotte E; Brown, Jeremy S; Choudhury, Gourab; Diar Bakerly, Nawar; Easom, Nicholas; Echevarria, Carlos; Fuld, Jonathan; Hart, Nick; Hurst, John R; Jones, Mark; Parekh, Dhruv; Pfeffer, Paul; Rahman, Najib M; Rowland-Jones, Sarah; Shah, Ajay M; Wootton, Dan G; Jolley, Caroline; Thompson, A A Roger; Chalder, Trudie; Davies, Melanie J; De Soyza, Anthony; Geddes, John R; Greenhalf, William; Heller, Simon; Howard, Luke; Jacob, Joseph; Jenkins, R Gisli; Lord, Janet M; Man, Will D-C; McCann, Gerry P; Neubauer, Stefan.
Afiliação
  • Leavy OC; Department of Population Health Sciences, University of Leicester, Leicester, UK.
  • Russell RJ; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Harrison EM; These authors contributed equally.
  • Lone NI; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Kerr S; These authors contributed equally.
  • Docherty AB; Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Sheikh A; The Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Richardson M; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
  • Elneima O; Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Greening NJ; Roslin Institute, University of Edinburgh, Edinburgh, UK.
  • Harris VC; Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Houchen-Wolloff L; The Usher Institute, University of Edinburgh, Edinburgh, UK.
  • McAuley HJC; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Saunders RM; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Sereno M; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Shikotra A; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Singapuri A; University Hospitals of Leicester NHS Trust, Leicester, UK.
  • Aul R; Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre-Respiratory, University of Leicester, Leicester, UK.
  • Beirne P; Department of Respiratory Sciences, University of Leicester, Leicester, UK.
  • Bolton CE; Therapy Department, University Hospitals of Leicester, NHS Trust, Leicester, UK.
  • Brown JS; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Choudhury G; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Diar Bakerly N; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Easom N; NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Echevarria C; The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Fuld J; St George's University Hospitals NHS Foundation Trust, London, UK.
  • Hart N; The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  • Hurst JR; University of Nottingham, Nottingham, UK.
  • Jones M; Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Parekh D; NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
  • Pfeffer P; UCL Respiratory, Department of Medicine, University College London, Rayne Institute, London, UK.
  • Rahman NM; University of Edinburgh, Edinburgh, UK.
  • Rowland-Jones S; NHS Lothian, Edinburgh, UK.
  • Shah AM; Manchester Metropolitan University, Manchester, UK.
  • Wootton DG; Salford Royal NHS Foundation Trust, Manchester, UK.
  • Jolley C; Infection Research Group, Hull University Teaching Hospitals, Hull, UK.
  • Thompson AAR; University of Hull, Hull, UK.
  • Chalder T; The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
  • Davies MJ; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
  • De Soyza A; Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Geddes JR; University of Cambridge, Cambridge, UK.
  • Greenhalf W; NIHR Cambridge Clinical Research Facility, Cambridge, UK.
  • Heller S; Lane Fox Respiratory Service, Guy's and St Thomas NHS Foundation Trust, London, UK.
  • Howard L; University College London, London, UK.
  • Jacob J; Royal Free London NHS Foundation Trust, London, UK.
  • Jenkins RG; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
  • Lord JM; NIHR Southampton Biomedical Research Centre, University Hospitals Southampton, Southampton, UK.
  • Man WD; University of Birmingham, Birmingham, UK.
  • McCann GP; University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
  • Neubauer S; Barts Health NHS Trust, London, UK.
ERJ Open Res ; 10(5)2024 Sep.
Article em En | MEDLINE | ID: mdl-39351379
ABSTRACT

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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article