Neurological

Methylprednisolone significantly better than dexamethasone in COVID-19

Treatment with methylprednisolone resulted in significantly greater improvements in clinical status and reduced hospital length of stay in hospitalized COVID-19 patients with hypoxia than treatment with dexamethasone, according to the results of a study published in BMC Infectious Diseases.

This prospective study included 86 hospital patients with COVID-19 in Iran. Participants were randomly assigned to either methylprednisolone 2 mg / kg / day (n = 44) or dexamethasone 6 mg / kg / day (n = 42). The treatment was administered along with the standard treatment for 10 days.

The primary endpoint was 28-day mortality and clinical status at 5 and 10 days. The data were examined with a 9-point ordinal scale of the World Health Organization (WHO), which ranges from not infected (point 0) to death (point 8). Secondary endpoints were ICU admission and the need for invasive mechanical ventilation.

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No significant differences in demographic variables, comorbidities, or disease severity at the time of admission were observed between the treatment groups. On day 5, however, patients treated with methylprednisolone achieved a significantly better clinical status compared to patients who received dexamethasone (4.02 vs. 5.21; P = 0.002). Patients in the methylprednisolone group also had a better clinical status on day 10 (2.90 vs 4.71; P = 0.001).

Patients in the methylprednisolone group had a significantly better mean 9-point WHO total score (3.909 vs 4.873; p = 0.004). The use of methylprednisolone was also associated with a significantly shorter mean hospital stay (7.43 ± 3.64 vs. 10.52 ± 5.47 days; P = 0.015). A smaller proportion of patients in the methylprednisolone group required a ventilator during their hospital stay (18.2% vs. 38.1%; p = 0.040).

Limitations of the study were the small sample size and the lack of robust data on computed tomography features and disease-related complications.

Investigators concluded that larger randomized trials with longer follow-up periods are needed to further investigate “the beneficial effects of methylprednisolone in patients with COVID-19 pneumonia”.

reference

Ranjbar K., Moghadami M, Mirahmadizadeh A, et al. Methylprednisolone or Dexamethasone, which is a superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial. BMC Infect Dis. 2021; 21 (1): 337. doi: 10.1186 / s12879-021-06045-3

This article originally appeared on Infectious Disease Advisor

Subjects:

COVID19 General Infectious Diseases General Neurological Treatments

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