Corticosteroids for COVID‐19 symptoms and quality of life at 1 year from admission

Abstract

The long-term evolution of COVID-19 is unknown, making it necessary to study the persistence of symptoms over time and their impact on quality of life in people who have had the disease. We analyzed these aspects 1 year after admission for COVID-19 and explored the influence of treatment with systemic corticosteroids during the acute phase of the illness. This observational cohort study took place in a tertiary hospital in March and April 2021 and included people admitted due to infection with SARS-CoV-2 in March, April, or May 2020. We excluded patients who had died, were unreachable or had substantial cognitive impairment. A telephone survey was undertaken to assess the presence of symptoms related to COVID-19 and to administer the SF-36 quality of life questionnaire. Other variables collected were demographic and clinical data along with the treatment received and the evolution over time. We analyzed 76 patients, including 44 who did not receive corticosteroids and 32 who did. Most symptoms were less frequent in the group that received corticosteroids, with statistically significant differences for headache, dysphagia, chest pain, and depression. These patients also showed significantly better outcomes in the SF-36 domains for "bodily pain" and "mental health."Corticosteroids administered in the acute phase of COVID-19 could attenuate the presence of long-term symptoms and improve patients' quality of life.

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of One-Year Follow-Up Studies on Post-COVID Symptoms

“…One important methodological concern when interpreting these studies on post-COVID symptoms is how to distinguish post-COVID symptoms from pre-COVID symptoms or the population's baseline level, especially for symptoms with a relatively low prevalence. In fact, six of the included studies [21,23,28,32,35,36] asked participants to take into account their pre-COVID state when reporting post-COVID symptoms (i.e., new or worsening symptoms compared with pre-COVID baseline) though such measurement relied on participants' recall accuracy. The afore-mentioned large-scale cohort study in Wuhan, China [25], included a matched non-COVID-19 control group, which showed that COVID-19 survivors had a significantly higher prevalence of all individual symptoms assessed at the one-year follow-up visit than the control population (proportion of having any one of the symptoms: 66% vs. 33%, p < 0.001).…”

“…Another largescale study in Spain [23] investigating persistent cough (which was reported by 2.5% of recruited COVID-19 survivors) showed no association between cough and sex, age, BMI, initial disease severity, days at hospital, and smoking status. One study [21] found that corticosteroids therapy received during hospitalisation was associated with lower risk of headache, dysphagia, chest pain, and depression at one-year follow-up; however, the aforementioned Chinese cohort study [25] showed that corticosteroids therapy was associated with increased risk of fatigue or muscle weakness and had no association with anxiety or depression one year later.…”

Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report

“…22 However, the frequency of headache and depression has been reported to be reduced at 1 year after admission in cases of COVID-19 undergoing steroid therapy. 23 In conclusion, we have reported a case with severe neuropsychiatric symptoms after mild respiratory symptoms from COVID-19.…”

Research Progress in the Treatment of Complications and Sequelae of COVID-19

“…In addition, it was demonstrated by Catalán IP et al that treatment with systemic corticosteroids during hospital admissions is associated with decreased long-term symptoms and improved quality of life, which could be explained by relieving intense inflammation during the acute phase of COVID-19 and subsequently reduce organ and tissue damages caused by SARS-CoV-2 infection. ( 83 ). Due to extensive use of anti-inflammatory drugs in the treatment of COVID-19, risk of late-onset complications has always been concerned.…”