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An ambispective cohort study aimed to distinguish between the clinical outcome and laboratory results of dexamethasone (DXM) 6 mg and methylprednisolone (MTP) high-dose in severely ill hospitalized SARS-CoV-2 patients diagnosed with pneumonia.
As compared to dexamethasone, the use of high-dose
methylprednisolone was significantly associated with decreased laboratory
markers, time of recovery, and the need for transfer to critical care unit.
An ambispective cohort study aimed to
distinguish between the clinical outcome and laboratory results of
dexamethasone (DXM) 6 mg and methylprednisolone (MTP) high-dose in severely
ill hospitalized SARS-CoV-2 patients diagnosed with pneumonia.
This study encompasses the survival analysis of 216 hospitalized patients suffering from severe Covid-19 pneumonia. The patients also had additional oxygen and radiological verification of pneumonia with the help of chest tomography.
As per hospital protocol, a total of 111 patients were treated with DXM 6 mg intravenously (IV) once daily for 7-10 days if they needed oxygen. As per the modified hospital protocol, a high dose (250-500 mg) of MTP was used every day for 3 days, followed by prednisone 50 mg daily for 14 days.
The protocol was not
applied in critical care unit (CCU), where administration of dexamethasone was
continued. The clinical outcome and differences in lab findings of
dexamethasone-recipients versus the prospective cohort that were given
methylprednisolone were assessed. Follow-up was conducted by outpatient
consultation after a month of hospital discharge or by phone, questioning about
readmission or living-dead status.
Out of 216 patients with Covid-19 pneumonia, 111 received DXM and 105 received MTP. More people (26.1%) in the DXM arm evolved to severe Acute Respiratory Distress Syndrome (ARDS) in comparison with the MTP arm (17.1%). Patients in the MTP group had considerably decreased laboratory markers of severity upon 4 days of treatment. Also, the transfer to the CCU and mortality was lower along with a shorter time of recovery in this group. More patients were alive in the MTP group than the DXM group at 30-day follow-up (Table 1):
The use of methylprednisolone 250-500 mg every day for 3
days followed by prednisone 50 mg taken orally daily for 2 weeks is a more
effective treatment option in COVID-19 people with pneumonia as compared
to dexamethasone 6 mg administered
intravenously once daily for 7-10 days.
PLoS One
Dexamethasone vs methylprednisolone high dose for Covid-19 pneumonia
Miguel Alejandro Pinzón et al.
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