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Title: High-dose methylprednisolone pulses for 3 days vs. low-dose dexamethasone for 10 days in severe, non-critical COVID-19: a retrospective propensity score matched analysis
Author: Mora Luján, José María
Tuells, Manel
Montero Saez, Abelardo
Formiga Pérez, Francesc
Homs Martí, Narcís
Albà-Albalate, Joan
Corbella, Xavier
Rubio-Rivas, Manuel
Keywords: COVID-19
Adrenocortical hormones
Issue Date: 28-Sep-2021
Publisher: MDPI
Abstract: Corticosteroids are largely recommended in patients with severe COVID-19. However, evidence to support high-dose methylprednisolone (MP) pulses is not as robust as that demonstrated for low-dose dexamethasone (DXM) in the RECOVERY trial. This is a retrospective cohort study on severe, non-critically ill patients with COVID-19, comparing 3-day MP pulses ≥ 100 mg/day vs. DXM 6 mg/day for 10 days. The primary outcome was in-hospital mortality, and the secondary outcomes were need of intensive care unit (ICU) admission or invasive mechanical ventilation (IMV). Propensity-score matching (PSM) analysis was applied. From March 2020 to April 2021, a total of 2,284 patients were admitted to our hospital due to severe, non-critically ill COVID-19, and of these, 189 (8.3%) were treated with MP, and 493 (21.6%) with DXM. The results showed that patients receiving MP showed higher in-hospital mortality (31.2% vs. 17.8%, p < 0.001), need of ICU admission (29.1% vs. 20.5%, p = 0.017), need of IMV (25.9% vs. 13.8, p < 0.001), and median hospital length of stay (14 days vs. 11 days, p < 0.001). Our results suggest that treatment with low-dose DXM for 10 days is superior to 3 days of high-dose MP pulses in preventing in-hospital mortality and need for ICU admission or IMV in severe, non-critically ill patients with COVID-19.
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It is part of: Journal of Clinical Medicine, 2021, vol. 10, num. 19, p. 4465
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ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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