Comparison of efficacy of methylprednisolone with dexamethasone in moderate to severe COVD-19 patients in a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20231893Keywords:
COVID-19, Methylprednisolone, Dexamethasone, Moderate to severeAbstract
Background: The aim was to compare efficacy of methylprednisolone with dexamethasone in moderate to severe COVID-19 patients in a tertiary care hospital.
Method: A retrospective observational study was conducted by collecting data of moderate to severe COVID-19 patients admitted to covid wards of a tertiary care hospital for a period of six months. Demographic data, information about SpO2 changes, duration of hospitalization, marker status and ventilation status were parameters collected and used to compare between two groups.
Results: Total number of patients in this study were 130. Out of which 65 patients who were on Methylprednisolone belonged to group A and 65 patients taking dexamethasone belonged to group B. In group A 56 (86.2%) were males and 9 (13.8%) were females. In group B 51 (78.5%) were males and 14 (21.5%) were females. Mean age in group A was 54.75±14.96 (age range b/w 25-80 years) and in group B was 55.43±15.83 (age range between 23-84 years). Patients in group A showed more presence of comorbidity (44.6%) as compared to group B (32.3%). Mean SpO2 level on day 1 in group A was 86.37±7.58 and in group B was 88.11±4.38. On day of discharge mean SpO2 level was 95.05±1.54 in group A and 94.63±2.09 in group B. Mean length of hospital stay in group A was 9.78±7.38 and in group B was 7.88±4.76. Improvement in marker status for group A was 100% and for group B 95.4%. Ventilation status in both groups showed 100% improvement.
Conclusions: Both steroids are effective in management of moderate to severe COVID-19 patients.
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References
Coronavirus Disease 2019 (COVID-19). Situation Report-58. World Health Organisation. 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200318-sitrep-58-covid-19.pdf. Accessed on 12th April 2023.
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. 2020;215:108427.
Xu Z, Shi L, Wang Y. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420-2.
Arabi YM, Mandourah Y, Al-Hameed F. Corticosteroid therapy for critically ill patients with Middle East respiratory syndrome. Am J Respir Crit Care Med. 2018;197:757-67.
Lee N, Allen Chan KC, Hui DS. Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients. J ClinVirol. 2004;31:304-9.
Meduri GU, Siemieniuk RAC, Ness RA, Seyler SJ. Prolonged low-dose methylprednisolone treatment is highly effective in reducing duration of mechanical ventilation and mortality in patients with ARDS. J Intensive Care. 2018;6:53.
Edalatifard M, Akhtari M, Salehi M, Naderi Z, Jamshidi A, Mostafaei S et al. Intravenous methylprednisolone pulse as a treatment for hospitalised severe COVID-19 patients; results from a randomised controlled clinical trial. Eur Respi J. 2020;56(6):2002808.
Sethi GR, Singhal KK. Pulmonary diseases and corticosteroids. Indian J. Pediatr. 2008;75(10):1045-56.
Marik PE. Steroids for sepsis: yes, no or maybe. J Thorac Dis. 2018;10(9):1070-7.
Kellog D, Gutierrez GC, Small CE, Stephens B, Sanchez P, Beg M et al. Safety and efficacy of methylprednisolone versus dexamethasone in critically ill patients with COVID-19 acute respiratory distress syndrome: a retrospective study. Ther Adv Infect Dis. 2023;546.
Fatima SA, Asif M, Khan KA, Siddique N, Khan AZ. Comparision of efficacy of dexamethasone and methylprednisolone in moderate to severe COVID-19 disease. Ann Med Surg. 2020;60:413-6.
El Mezzeoul, El Aldouni G, Merbouh M, El Kaouini A, Aftiss F Z, Berrichi S et al. Dexamethasone or methylprednisolone therapy in COVID-19 pneumonia: A retrospective and comparative study of 513 cases. Ann Med Surg. 2021;70:102858.
Ranjbar K, Moghadami M, Mirahmadizadeh A. Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial. BMC Infect Dis. 2021;21.
Ko JJ, Wu C, Mehta N, Wald Dicler N, Yang W, Qiao R. A comparison of methylprednisolone and dexamethasone in intensive care patients with COVID-19. J Intensive Care Med. 2021;36(6):673-80.
Pinzon MA, Holguin H, Betancur JF, Crdona Arango D, Laniado H, Arias C et al. Dexamethasone vs methylprednisolone high dose for COVID-19 pneumonia. PLoS One. 2021;16:(5).