A Retrospective Data Audit of Outcome of Moderate and Severe Covid-19 Patients Who Had Received MP and Dex: A Single Center Study

• Published in: Infection and drug resistance 2024, Vol.17, p.5491
• Main Authors: Li, Yupeng, Dong, Chuanchuan, Xing, Yanqing, Ma, Xinkai, Ma, Zhen, Zhang, Lulu, Du, Xianglin, Feng, Liting, Huo, Rujie, Wu, Qian Nan, Li, Peiqi, Hu, Fei, Liu, Dai, Dong, Yanting, Cheng, Erjing, Tian, Xinrui, Tian, Xinli
• Format: Article
• Language: English
• Subjects: Coronaviruses; COVID-19; Cytokine storm; Dexamethasone; Edema; Global health; Hospitals; Hyperglycemia; Infections; Lung diseases; Mechanical ventilation; Medical prognosis; Medical research; Methylprednisolone; Mortality; Multiple organ dysfunction syndrome; Oxygen saturation; Pandemics; Patients; Physiology; Pulmonary fibrosis; Research methodology; Statistical analysis; Ventilators
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S418788

To evaluate the necessity of the application of glucocorticoid (GC) in moderate COVID-19 patients, and which is the optimal choice between methylprednisolone (MP) and dexamethasone (DEX) in the clinical use of GC in different types of COVID-19 patients. The study included patients with COVID-19 in Shanxi, China, from December 18, 2022, to March 1, 2023. The main clinical outcomes were 30-day mortality, disease exacerbations, and hospitalization days. Secondary outcomes included the demand for non-invasive ventilator-assisted ventilation (NIPPV)/invasive mechanical ventilation (IMV), the need for GC regimen escalation in follow-up treatment, duration of GC treatment, and complications including hyperglycemia and fungal infection. In moderate patients (N = 351), the rate of exacerbation and the need for GC regimen escalation in follow-up treatment was highest in the no-use GC group (P = 0.025, P = 0.01), the rate of fungal infections was highest in the DEX group (P = 0.038), and MP 40 mg/day or DEX 5 mg/day reduced exacerbations with consistent effects. In severe patients (N = 371), the two GC regimens do not affect their 30-day mortality and exacerbation rate, but the number of hospital days was significantly lower in the MP group compared with the DEX group (P < 0.001). GC use is beneficial in mitigating exacerbations in moderate patients and in patients with moderate COVID-19. In severe patients, MP reduces the number of hospitalization days compared with DEX and may be a superior choice.