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714461.pdf (1.99 MB)

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2021-09-28

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cc-by (c) Mora Luján, José María et al., 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/181150

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

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https://doi.org/10.3390/jcm10194465

Resum

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.

Matèries

COVID-19, Corticosteroides, Mortalitat

Matèries (anglès)

COVID-19, Adrenocortical hormones, Mortality

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

MORA LUJÁN, José María, et al. 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. Journal of Clinical Medicine. 2021. Vol. 10, num. 19, pags. 4465. ISSN 2077-0383. [consulted: 11 of August of 2026]. Available at: https://hdl.handle.net/2445/181150

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