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Supplementary Table 1. Association of variables and in-hospital mortality in severe COVID-19 patients in univariable Cox regression analysis. VariablesHR (95% CI)P valueAge1.06 (1.05, 1.08)<0.001Gender (Female vs Male)0.54 (0.36, 0.79)0.002Diabetes1.51 (0.92, 2.45)0.100Hypertension1.38 (0.92, 2.07)0.124COPD2.81 (1.30, 6.07)0.008CKD3.26 (1.43, 7.44)0.005Smoking1.69 (1.04, 2.75)0.033Admission glucose1.10 (1.06, 1.13)<0.001Admission lymphocyte counts0.14 (0.08, 0.25)<0.001Admission neutrophil counts1.25 (1.21, 1.29)<0.001Admission platelet counts0.99 (0.99, 1.00)<0.001Admission hemoglobin1.01 (1.00, 1.02)0.227Admission CRP1.01 (1.01, 1.01)<0.001Admission SpO20.92 (0.91, 0.93)<0.001Admission LDH1.00 (1.00, 1.00)<0.001Admission AST1.00 (1.00, 1.00)<0.001Admission ALT1.00 (1.00, 1.01)<0.001Admission D-Dimer1.09 (1.06, 1.12)<0.001Admission Creatinine1.00 (1.00, 1.00)0.019Admission BUN1.07 (1.05, 1.09)<0.001Systemic corticosteroid use4.93 (3.17, 7.68)<0.001Cox regression with time-varying exposureSystemic corticosteroid use6.41 (4.09, 10.04)<0.001COVID-19 = coronavirus disease 2019; HR = hazard ratio; CI = confidence interval; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 2. Baseline comparison between corticosteroid use and no corticosteroid use groups after inverse probability of treatment weighted in severe COVID-19 patients. VariablesNo (n=1645)Yes (n=1511)P valueSMDAge, y63.0 (51.0, 71.0)62.0 (50.0, 70.0)0.4220.068Female, n (%)807 (49.0)735 (48.6)0.9190.009Comorbid conditions, n (%)Diabetes 207 (12.6)223 (14.8)0.4970.064Hypertension 396 (24.1)377 (25.0)0.8240.021COPD50 (3.1)73 (4.8)0.4010.089Cancer22 (1.3)24 (1.6)0.7630.020CKD30 (1.8)31 (2.0)0.8360.014Smoking249 (15.1)182 (12.0)0.3580.091Admission laboratory valuesAdmission glucose, mmol/L6.1 (5.1, 7.8)6.4 (5.4, 7.8)0.1290.123Lymphocyte counts, 109/L0.9 (0.6, 1.3)1.0 (0.7, 1.5)0.2290.184Neutrophil counts, 109/L3.9 (2.7, 5.7)4.0 (2.7, 5.5)0.7690.112Platelet counts, 109/L194.0 (140.0, 245.9)198.0 (150.0, 264.0)0.2980.110Hemoglobin, g/L126.2 (117.0, 137.0)127.0 (114.0, 139.0)0.7690.008CRP, mg/L26.9 (4.3, 59.9)31.4 (10.7, 44.6)0.1500.007SpO2, %98.0 (95.0, 99.0)96.9 (95.0, 99.0)0.0500.109LDH, U/L235.3 (179.8, 341.4)231.0 (188.8, 315.0)0.9610.143AST, U/L27.0 (18.0, 40.4)27.9 (21.0, 40.0)0.1110.004ALT, U/L25.8 (16.0, 38.0)24.2 (17.0, 36.8)0.9260.010D-Dimer, mg/L0.5 (0.3, 1.0)0.4 (0.2, 0.8)0.0670.151Creatinine, μmol/L70.0 (58.1, 85.4)71.0 (60.0, 90.0)0.4480.127BUN, mmol/L4.6 (3.6, 6.2)4.6 (3.6, 5.8)0.5400.173COVID-19 = coronavirus disease 2019; SMD = standardized mean difference; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 3. Baseline comparison between corticosteroid use and no corticosteroid use groups after propensity score matching in severe COVID-19 patients. VariablesNo (n=360)Yes (n=360)P valueAge, y62.0 (52.0, 70.0)62.0 (50.0, 70.0)0.502Female, n (%)173 (48.1)178 (49.4)0.766Comorbid conditions, n (%)Diabetes 47 (13.1)46 (12.8)1.000Hypertension 84 (23.3)79 (21.9)0.722COPD12 (3.3)11 (3.1)1.000Cancer4 (1.1)5 (1.4)1.000CKD8 (2.2)6 (1.7)0.788Smoking44 (12.2)44 (12.2)1.000Admission laboratory valuesAdmission glucose, mmol/L6.2 (5.3, 8.1)6.5 (5.4, 7.7)0.257Lymphocyte counts, 109/L0.8 (0.6, 1.1)0.8 (0.6, 1.1)0.824Neutrophil counts, 109/L3.9 (2.6, 5.3)3.9 (2.7, 5.5)0.887Platelet counts, 109/L190.5 (144.5, 239.0)185.5 (144.0, 241.0)0.674Hemoglobin, g/L128.0 (115.0, 138.0)127.0 (116.0, 138.0)0.926CRP, mg/L33.5 (7.7, 66.9)34.2 (15.6, 51.6)0.547SpO2, %97.0 (95.0, 99.0)96.0 (94.0, 98.0)0.002LDH, U/L253.7 (201.0, 339.4)257.6 (197.5, 327.0)0.736AST, U/L27.2 (18.7, 41.0)28.8 (22.0, 42.5)0.035ALT, U/L25.8 (16.1, 38.8)24.3 (16.0, 39.0)0.875D-Dimer, mg/L0.4 (0.3, 0.8)0.4 (0.2, 0.9)0.032Creatinine, μmol/L70.1 (59.7, 85.7)70.4 (60.0, 87.0)0.723BUN, mmol/L4.5 (3.6, 6.0)4.5 (3.5, 5.7)0.373COVID-19 = coronavirus disease 2019; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 4. Association of variables and in-hospital mortality in critical COVID-19 patients in univariable Cox regression analysis. VariablesHR (95% CI)P valueAge1.02 (1.00, 1.03)0.020Gender (Female vs Male)0.70 (0.44, 1.10)0.123Diabetes1.15 (0.70, 1.87)0.588Hypertension1.06 (0.69, 1.63)0.792COPD0.64 (0.29, 1.41)0.270Cancer0.83 (0.20, 3.39)0.797CKD1.36 (0.59, 3.12)0.468Smoking1.64 (1.04, 2.59)0.035Admission glucose1.07 (1.03, 1.11)0.001Admission lymphocyte counts0.53 (0.31, 0.88)0.015Admission neutrophil counts1.09 (1.06, 1.13)<0.001Admission platelet counts1.00 (0.99, 1.00)0.075Admission hemoglobin1.00 (0.99, 1.02)0.570Admission CRP1.01 (1.00, 1.01)<0.001Admission SpO20.94 (0.93, 0.95)<0.001Admission LDH1.00 (1.00, 1.00)<0.001Admission AST1.00 (1.00, 1.00)0.803Admission ALT1.00 (1.00, 1.00)0.869Admission D-Dimer1.07 (1.05, 1.10)<0.001Admission Creatinine1.00 (1.00, 1.00)<0.001Admission BUN1.05 (1.03, 1.07)<0.001Systemic corticosteroid use3.13 (1.76, 5.57)<0.001Cox regression with time-varying exposureSystemic corticosteroid use4.10 (2.34, 7.18)<0.001COVID-19 = coronavirus disease 2019; HR = hazard ratio; CI = confidence interval; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 5. Baseline comparison between corticosteroid use and no corticosteroid use groups after inverse probability of treatment weighted in critical COVID-19 patients. VariablesNo (n=240)Yes (n=253)P valueSMDAge, y67.0 (57.0, 75.1)67.0 (58.0, 74.6)0.8930.046Female, n (%)84.1 (35.1)100.1 (39.6)0.5780.094Comorbid conditions, n (%)Diabetes 66 (27.4)57 (22.6)0.5530.112Hypertension 90 (37.7)111 (43.7)0.4840.122COPD21 (8.8)23 (9.2)0.9340.011Cancer3 (1.2)6 (2.3)0.5690.080CKD15 (6.2)19 (7.5)0.7600.055Smoking78 (32.6)55 (21.6)0.2380.250Admission laboratory valuesAdmission glucose, mmol/L6.5 (5.6, 7.9)7.1 (5.8, 8.4)0.2640.023Lymphocyte counts, 109/L0.7 (0.4, 1.0)0.7 (0.4, 1.1)0.5580.021Neutrophil counts, 109/L4.7 (3.3, 8.3)4.8 (3.4, 7.6)0.9740.070Platelet counts, 109/L186.0 (146.5, 261.7)186.5 (136.0, 241.2)0.5060.198Hemoglobin, g/L123.5 (102.1, 135.0)124.3 (114.0, 136.0)0.3450115CRP, mg/L51.1 (18.6, 132.5)68.2 (20.7, 133.6)0.7460.059SpO2, %96.1 (89.0, 98.5)94.5 (90.0, 98.0)0.4340.205LDH, U/L306.4 (188.5, 572.9)307.4 (205.0, 524.2)0.9370.029AST, U/L30.9 (22.6, 57.2)32.5 (20.0, 47.7)0.4480.141ALT, U/L22.5 (16.8, 41.8)24.8 (15.7, 41.0)0.6690.111D-Dimer, mg/L0.9 (0.5, 2.0)0.6 (0.4, 1.6)0.1730.085Creatinine, μmol/L81.6 (64.5, 115.0)75.5 (60.8, 104.4)0.4250.118BUN, mmol/L6.0 (4.4, 8.3)5.5 (4.3, 8.9)0.5580.150COVID-19 = coronavirus disease 2019; SMD = standardized mean difference; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 6. Baseline comparison between corticosteroid use and no corticosteroid use groups after propensity score matching in critical COVID-19 patients. VariablesNo (n=60)Yes (n=60)P valueAge, y70.0 (53.0, 86.5)67.5 (58.5, 77.0)0.727Female, n (%)25 (41.7)27 (45.0)0.854Comorbid conditions, n (%)Diabetes 14 (23.3)14 (23.3)1.000Hypertension 22 (36.7)22 (36.7)1.000COPD8 (13.3)7 (11.7)1.000Cancer1 (1.7)1 (1.7)1.000CKD4 (6.7)3 (5.0)1.000Smoking12 (20.0)13 (21.7)1.000Admission laboratory valuesAdmission glucose, mmol/L6.7 (5.6, 7.8)6.8 (5.7, 7.9)0.637Lymphocyte counts, 109/L0.8 (0.6, 1.1)0.8 (0.5, 1.2)0.927Neutrophil counts, 109/L4.2 (3.3, 6.9)3.9 (3.0, 5.7)0.228Platelet counts, 109/L187.0 (149.0, 246.5)184.5 (135.5, 237.0)0.234Hemoglobin, g/L122.2 (108.5, 135.5)119.5 (112.5, 134.5)0.950CRP, mg/L50.1 (22.6, 125.9)61.7 (20.8, 128.7)0.854SpO2, %97.2 (95.0, 99.0)97.0 (93.7, 99.0)0.472LDH, U/L251.2 (166.6, 408.2)266.3 (194.6, 359.9)0.954AST, U/L26.8 (19.4, 50.8)30.9 (20.1, 44.0)0.929ALT, U/L21.1 (15.1, 38.0)22.4 (16.2, 34.1)0.719D-Dimer, mg/L0.7 (0.4, 1.7)0.5 (0.3, 0.8)0.061Creatinine, μmol/L80.0 (57.0, 100.8)73.5 (57.3, 105.6)0.781BUN, mmol/L5.7 (4.1, 7.9)5.5 (4.2, 7.0)0.644COVID-19 = coronavirus disease 2019; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; CRP = C-reactive protein; LDH = lactate dehydrogenase; AST = aspartate aminotransferase; ALT = alanine aminotransferase; BUN = blood urea nitrogen.Supplementary Table 7. Blood glucose level and lymphocyte counts in severe and critical COVID-19 patients with or without corticosteroid use. VariablesMedian (IQR)P value*Severe casesBlood glucose level, mmol/L No corticosteroid use5.6 (4.9, 6.7)<0.001 Before corticosteroid use6.2 (5.3, 7.7)<0.001 During corticosteroid use7.2 (5.9, 9.0)- After corticosteroid use5.5 (4.8, 7.0)<0.001Lymphocyte counts, 109/L No corticosteroid use1.3 (1.0, 1.6)<0.001 Before corticosteroid use0.8 (0.6, 1.0)0.782 During corticosteroid use0.8 (0.5, 1.0)-After corticosteroid use1.2 (0.9, 1.5)<0.001Critical casesBlood glucose level, mmol/LNo corticosteroid use6.4 (5.2, 7.7)<0.001Before corticosteroid use7.1 (5.9, 8.8)<0.001During corticosteroid use7.5 (6.3, 9.6)-After corticosteroid use7.0 (6.0, 10.4)<0.001Lymphocyte counts, 109/LNo corticosteroid use1.1 (0.8, 1.5)<0.001Before corticosteroid use0.6 (0.5, 1.0)0.214During corticosteroid use0.7 (0.4, 1.0)-After corticosteroid use0.9 (0.6, 1.3)<0.001COVID-19 = coronavirus disease 2019; IQR = interquartile range.* P value is compared with the blood glucose level or lymphocyte counts during corticosteroid use. ................
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