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Original Article
- Infection
- Methylprednisolone pulse therapy for critically ill patients with COVID-19: a cohort study
- Keum-Ju Choi, Soo Kyun Jung, Kyung Chan Kim, Eun Jin Kim
- Acute Crit Care. 2023;38(1):57-67. Published online February 7, 2023
- DOI: https://doi.org/10.4266/acc.2022.00941
- Correction in: Acute Crit Care 2023;38(2):249
- 11,052 View
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- 4 Web of Science
- 4 Crossref
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Abstract
PDF - Background
The guidelines recommend the use of dexamethasone 6 mg or an equivalent dose in patients with coronavirus disease 2019 (COVID-19) who require supplemental oxygen. Given that the severity of COVID-19 varies, we investigated the effect of a pulse dose of corticosteroids on the clinical course of critically ill patients with COVID-19.
Methods
This single-center, retrospective cohort study was conducted between September and December 2021, which was when the Delta variant of the COVID-19 virus was predominant. We evaluated the mortality and oxygenation of severe to critical COVID-19 cases between groups that received dexamethasone 6 mg for 10 days (control group) and methylprednisolone 250 mg/day for 3 days (pulse group).
Results
Among 44 patients, 14 and 30 patients were treated with control steroids and pulse steroids, respectively. There was no difference in disease severity, time from COVID-19 diagnosis to steroid administration, or use of remdesivir or antibacterial agents between the two groups. The pulse steroid group showed a significant improvement in oxygenation before and after steroid treatment (P<0.001) compared with the control steroid group (P=0.196). There was no difference in in-hospital mortality (P=0.186); however, the pulse steroid group had a lower mortality rate (23.3%) than the control steroid group (42.9%). There was a significant difference in the length of hospital stay between both two groups (P=0.039).
Conclusions
Pulse steroids showed no mortality benefit but were associated with oxygenation improvement and shorter hospital stay than control steroids. Hyperglycemia should be carefully monitored with pulse steroids. -
Citations
Citations to this article as recorded by
- The relationship between steroid treatment and mortality in patients with COVID-19 followed up in an intensive care unit
Huseyin Ali Ozturk, Fatih Necip Arici
PeerJ.2025; 13: e18606. CrossRef - Baricitinib and Pulse Steroids Combination Treatment in Hyperinflammatory COVID-19: A Rheumatological Approach in the Intensive Care Unit
Francesco Ferro, Gaetano La Rocca, Elena Elefante, Nazzareno Italiano, Michele Moretti, Rosaria Talarico, Erika Pelati, Katia Valentini, Chiara Baldini, Roberto Mozzo, Luigi De Simone, Marta Mosca
International Journal of Molecular Sciences.2024; 25(13): 7273. CrossRef - Comparative Efficacy of Inhaled and Intravenous Corticosteroids in Managing COVID-19-Related Acute Respiratory Distress Syndrome
Ahmed A. Abdelkader, Bshra A. Alsfouk, Asmaa Saleh, Mohamed E. A. Abdelrahim, Haitham Saeed
Pharmaceutics.2024; 16(7): 952. CrossRef - Dosage and utilization of dexamethasone in the management of COVID-19: A critical review
Imran Sethi, Asim Shaikh, Musa Sethi, Hira Khalid Chohan, Sheraz Younus, Syed A Khan, Salim Surani
World Journal of Virology.2024;[Epub] CrossRef
- The relationship between steroid treatment and mortality in patients with COVID-19 followed up in an intensive care unit
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