2026-04-17T14:24:30Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/143592026-03-20T16:14:46Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc García-Onrubia, Jorge author Feltes, Gisela author Vazirani Ballesteros, Ravi author Sánchez del Hoyo, Rafael author Viana-Llamas, María C. author RAPOSEIRAS-ROUBIN, SERGIO author Uribarri, Aitor author 2026-03-19T12:28:56Z 2026-03-19T12:28:56Z 2025-10 SARS-CoV-2 infection; Corticosteroid therapy; Pre-existing heart disease Infecció per SARS-CoV-2; Teràpia amb corticoesteroides; Malaltia cardíaca preexistent Infección por SARS-CoV-2; Terapia con corticoesteroides; Enfermedad cardíaca preexistente Introduction: Corticosteroid therapy has been demonstrated to improve prognosis and reduce mortality in patients with severe Coronavirus Disease 2019 (COVID-19) infection by attenuating the exaggerated inflammatory response that emerges in the late phase of infection. However, its impact on patients with pre-existing cardiovascular disease, who are at higher risk of complications, has not been specifically studied. The aim of this study is to evaluate the effect of corticosteroid therapy on mortality and long-term COVID-19 symptoms in this high-risk population. Methods: We analyzed the prospective registry HOPE-2. Patients with previous cardiovascular disease were selected, and 18-month all-cause death was defined as the primary endpoint. Long-term COVID-19 symptoms were considered as secondary endpoints. A total of 1188 patients with previous heart disease were included, of which 453 received corticosteroid treatment. Propensity score matching analysis in a 1:1 fashion was performed based on baseline variables that exhibited a p-value < 0.05 in the univariant analysis and outcome variables that defined corticosteroid use, with a final matched population of 796 patients. Results: In patients with pre-existing heart disease, corticosteroid treatment was not associated with differences in 18-month all-cause mortality (p = 0.52). However, a shorter duration of hospitalization (median: 8 days [IQR: 4–14] and 11 days [IQR: 7–18]; p < 0.001) was observed in patients who received corticosteroids. No significant differences in long-term COVID-19 symptoms were observed between the two groups. Conclusions: In patients with pre-existing heart disease, the absence of a clear harmful effect suggests that the positive effects of corticosteroids may be offset by their potential adverse effects which could contribute to the persistence of long COVID symptoms. This finding may reflect a differential response to corticosteroids in this high-risk subgroup, highlighting the need for further studies to clarify the role of this therapy in such patients. https://hdl.handle.net/11351/14359 COVID-19 (Malaltia) - Tractament COVID-19 (Malaltia) - Prognosi Corticosteroides - Ús terapèutic Sistema cardiovascular - Malalties CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones Other subheadings::Other subheadings::/therapeutic use DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections Other subheadings::Other subheadings::Other subheadings::/drug therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis DISEASES::Cardiovascular Diseases COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal Otros calificadores::Otros calificadores::/uso terapéutico ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico ENFERMEDADES::enfermedades cardiovasculares The Long-Term Outcomes of Corticosteroid Use in COVID-19 Patients with Cardiovascular Disease: A Propensity-Matched Analysis from the Multi-Center International Prospective Registry (HOPE-2)