Background: Several studies have reported the beneficial effect of glucocorticoids in the treatment of cytokine storm that occurs in patients with severe COVID-19. Various glucocorticoids regimens have been proposed .

Methods: Retrospective observational study that includes patients with severe SARS-CoV-2 pneumonia and compares admission to an Intensive Care Unit (ICU) or death during hospitalization in three groups of patients: no glucocorticoids treatment, use of glucocorticoids doses equivalent to less than 250 mg of prednisone daily and use of equivalent doses greater than or equal to 250 mg of prednisone daily . Multivariate analysis was performed using logistic regression, using the propensity index as a covariant .

Results: Of the 259 patients enrolled in the study, 67 (25.9 %) had an unfavorable evolution, dying or requiring ICU admission . Comparative analyzes between different glucocorticoids treatments and the association with ICU admission or death were: glucocorticoids treatment (any dose) versus no glucocorticoids treatment (OR : 0.71 (0.30-1.66) ), treatment with glucocorticoids (≥ 250 mg prednisone daily) versus no glucocorticoids treatment (OR : 0.35 (0.11-1.08) ) and glucocorticoids treatment (≥ 250 mg prednisone daily) versus patients with glucocorticoids doses <250 mg prednisone daily or without glucocorticoids treatment (OR : 0.30 (0.10-0.88) ). Conclusion: The results of this study show that patients with severe SARS-CoV-2 pneumonia treated with glucocorticoids pulses with equivalent doses of prednisone greater than or equal to 250 mg have a more favorable evolution (less mortality and less admission to ICU).