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
Mora-Luján, José María
Homs, Narcís A.
Corbella Virós, Xavier
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.
61 - Medicina
616.9 - Malalties infeccioses i contagioses. Febres
Is part of
Journal of Clinical Medicine
Mora-Luján, José María; Tuells, Manel; Montero, Abelardo [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, 10(19), 4465. Disponible en: <https://www.mdpi.com/2077-0383/10/19/4465>. Fecha de acceso: 18 oct. 2021. DOI: 10.3390/jcm10194465
This item appears in the following Collection(s)
- Ciències de la Salut 
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/