An evaluation of the indications for and implications of corticosteroid use in intensive care units-admitted coronavirus disease 2019 patients

Background: The use of corticosteroids (CSs) in managing coronavirus disease 2019 (COVID-19) is a significant concern for healthcare professionals. The aim of this is to evaluate the indications for, and implications of, CS use in severe acute respiratory syndrome coronavirus 2 patients. Methods: A single-centered, retrospective, and quantitative study conducted at a tertiary care hospital. All patients ( n = 107) were admitted to the intensive care units (ICU) between March 1 and December 31, 2020. Demographic and clinical profiles were obtained from health records. Mortality, mechanical ventilation (MV) days, procalcitonin (PCT), and C-reactive protein levels were compared between CS and non-CS groups. Descriptive statistics include frequency and percentages. Inferential statistics include odds ratio, correlation coefficients, regressions, and analysis of variance. Results: The mean age of patients (84 males, 23 females) was 57.2 + 12.92 years (standard deviation: 12.92). The number who received CSs ( n = 75, 70.1%) was higher than the non-CS group ( n = 32, 29.9%). Mean PCT was significantly higher in the CS group compared to non-CS (0.47 ± 0.71 vs. 0.14 ± 0.61 ng/mL, P < 0.001). The mean number of days on MV was significantly higher in CS than in non-CS patients (9.6 days vs. 5.4 days). The study shows that the mortality percentage in the steroid group, 50.6% (38/75), was significantly higher compared to those who did not receive steroids 18.75% (6/32) ( P = 0.01). Conclusions: This study indicates that CS use in ICU-admitted COVID-19 patients is associated with an increased incidence of mortality, and this was not correlated with baseline immune status. Furthermore, steroid administration is significantly associated with a longer duration of MV. The findings suggest that CSs should be used with specific indications rather than broadly administered to all COVID-19 patients requiring intensive care. In addition, steroid use did not significantly increase the risk of secondary bacterial infections. Further studies are recommended to refine the criteria for CS use in this patient population.