Glucocorticoid treatment during COVID-19 infection: does it affect the incidence of long COVID?, 2024, Specktor et al

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Glucocorticoid treatment during COVID-19 infection: does it affect the incidence of long COVID?

Polina Specktor, Dana Hadar & Hilla Cohen

Published: 03 October 2024

Background
Long COVID (LC) is a frequent complication of COVID infection. It usually results in cognitive impairment, myalgia, headache and fatigue. No effective treatment has been found yet. We aimed to explore the effect of glucocorticoid (GC) treatment during COVID-19 infection on the later development of LC.

Methods
We examined electronic health records from Clalit Health Services for documentation of COVID-19, GC treatment, and LC frequency. Background diagnoses, demographic data, hospitalization rates, and the use of anti-COVID drugs were recorded.

Results
1,322,599 cases of COVID-19 infection met the inclusion criteria; 13,530 patients (1.02%) received GC treatment. 149,272 patients, 11.29% of COVID-19 patients were diagnosed with LC. Age and female gender were prognostic risk factors for LC (OR 1.06 for age, OR 1.4 for female gender; p value < 0.0001). Background psychiatric diagnoses, migraine, backache and irritable bowel syndrome were predisposing conditions for LC (OR 2.7, p value < .0001). Higher BMI was associated with a greater probability of LC (OR of 1.25 for obese population).

COVID patients who received GC were diagnosed with LC more frequently: 2294 cases (16.95%) compared to 146,978 cases (11.23%) in the non-GC group; (adjusted OR of 1.28 ± 0.07, 95% CI, p < 0.0001).

Conclusions
GC treatment during COVID-19 is correlated with the development of LC. In vivo and animal models may be used to explore the mechanism of this correlation. Future directions include prospective studies as well.

Link (Inflammopharmacology) [Paywall]

 

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There was a response to this paper which @Nightsong summarized:

The association between glucocorticoids and long COVID (2025, Inflammopharmacology)

A letter to the editor, commenting on a recent study which linked glucocorticoid therapy in COVID-19 patients to an increased risk of long COVID. The authors suggest caution in interpreting its results, mentioning potential confounding factors (disease severity, inflammation levels) & study limitations (lack of information about dosage, timing, treatment duration). They recommend that future research includes subgroup analyses involving factors such as inflammation severity & cortisol levels.