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Observational Study
. 2025 Apr 26;25(1):201.
doi: 10.1186/s12890-025-03659-0.

Corticosteroids and long-term pulmonary function after critical illness due to COVID-19- a single-center cohort study

Mari Roël  1   2 , Anna Schandl  3   4 , Sandra Jonmarker  3   4 , Anders Hedman  3   5 , Gisela Vogel  3   4 , Eva Joelsson-Alm  3   4 , Maria Cronhjort  6 , Pernilla Darlington  7   3
Affiliations
Observational Study

Corticosteroids and long-term pulmonary function after critical illness due to COVID-19- a single-center cohort study

Mari Roël et al. BMC Pulm Med. .

Abstract

Background: Early in the pandemic, corticosteroids became standard treatment for patients with critical COVID-19 infections. This study aimed to investigate the possible long-term pulmonary consequences after corticosteroid treatment in patients with critical COVID-19 requiring ventilatory support.

Methods: This observational single-center cohort study included patients treated for critical COVID-19 requiring ventilatory support between March 1, 2020, and August 1, 2021, with a 6-month follow-up after discharge from the intensive care unit. Corticosteroid treatment was defined according to the RECOVERY trial (6 mg dexamethasone daily or equivalent dose of another corticosteroid, initiated within eight days of hospital admittance and continued for at least one day) Pulmonary function was assessed by diffusion capacity for carbon monoxide. Health-related quality of life was measured with the questionnaire RAND-36. General linear regression was used to present mean score differences with 95% confidence intervals.

Results: Among the 456 (69%) critically ill COVID-19 patients who survived at least 90 days after ICU discharge, 286 (63%) attended the follow-up six months later. The groups were balanced regarding invasive ventilation; 47% received invasive ventilation in both groups. Corticosteroid treatment was associated with a lower diffusion capacity for carbon monoxide (MSD - 8.3, 95% CI: -14.2 to -2.4) 6 months after ICU discharge (change > 10% were regarded as clinically significant). There were no differences in health-related quality of life between the groups.

Conclusions: Corticosteroids might negatively impact pulmonary function after critical COVID-19. The decrease did not seem to influence health-related quality of life. Future studies are needed to confirm the results.

Keywords: COVID-19; Corticosteroids; Intensive care; Long-term effects.

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Conflict of interest statement

Declarations. Ethical approval: Study approval was granted from the Swedish Ethical Review Authority (Dnr 2020–03760, 2020–06106 and 2022-03531-02). The study adhered to the Declaration of Helsinki. Written informed consent was obtained from all included participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study inclusion, left shows patients without corticosteroid treatment and right corticosteroid treatment
See this image and copyright information in PMC

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