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.

COVID-19 corticosteroids dexamethasone methylprednisolone mortality

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
28 Sep 2021
Historique:
received: 05 08 2021
revised: 14 09 2021
accepted: 25 09 2021
entrez: 13 10 2021
pubmed: 14 10 2021
medline: 14 10 2021
Statut: epublish

Résumé

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%,

Identifiants

pubmed: 34640481
pii: jcm10194465
doi: 10.3390/jcm10194465
pmc: PMC8509662
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
PLoS One. 2021 Jan 28;16(1):e0243964
pubmed: 33507958
Chest. 2021 Mar;159(3):1019-1040
pubmed: 33129791
Clin Infect Dis. 2020 Nov 19;71(16):2199-2206
pubmed: 32407459
Hypertension. 2021 Mar 3;77(3):856-867
pubmed: 33377393
Intensive Care Med. 2021 May;47(5):521-537
pubmed: 33876268
J Med Virol. 2021 Jan;93(1):250-256
pubmed: 32592501
J Clin Med. 2020 Oct 29;9(11):
pubmed: 33137919
BMJ. 2020 Jul 30;370:m2980
pubmed: 32732190
J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):e28-e37
pubmed: 33103720
PLoS One. 2021 Mar 11;16(3):e0248132
pubmed: 33705495
JAMA. 2020 Oct 6;324(13):1298-1306
pubmed: 32876689
PLoS One. 2020 Sep 22;15(9):e0239401
pubmed: 32960899
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Clin Infect Dis. 2020 Apr 27;:
pubmed: 32338708
Clin Microbiol Infect. 2021 Feb;27(2):244-252
pubmed: 32860964
BMC Med. 2020 Nov 16;18(1):359
pubmed: 33190637
JAMA. 2020 Oct 6;324(13):1307-1316
pubmed: 32876695
JAMA. 2020 Oct 6;324(13):1317-1329
pubmed: 32876697
JAMA. 2020 Oct 6;324(13):1330-1341
pubmed: 32876694
Clin Infect Dis. 2020 Nov 19;71(16):2114-2120
pubmed: 32427279
Aging (Albany NY). 2020 Apr 8;12(7):6049-6057
pubmed: 32267833
China CDC Wkly. 2020 Feb 21;2(8):113-122
pubmed: 34594836
Clin Infect Dis. 2021 May 4;72(9):e373-e381
pubmed: 32785710
Eur Respir J. 2020 Dec 24;56(6):
pubmed: 32943404
Chest. 2009 Dec;136(6):1631-1643
pubmed: 19801579
Ann Rheum Dis. 2002 Aug;61(8):718-22
pubmed: 12117678
Intensive Care Med. 2017 Dec;43(12):1781-1792
pubmed: 28940017
Wien Klin Wochenschr. 2021 Apr;133(7-8):303-311
pubmed: 33534047
Eur Respir J. 2020 May 7;55(5):
pubmed: 32269088

Auteurs

José María Mora-Luján (JM)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Manel Tuells (M)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Abelardo Montero (A)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Francesc Formiga (F)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Narcís A Homs (NA)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Joan Albà-Albalate (J)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Xavier Corbella (X)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
School of Medicine, Universitat Internacional de Catalunya, 08195 Barcelona, Spain.

Manuel Rubio-Rivas (M)

Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

Classifications MeSH