Soo, Chun Ian and Poon, Khai Vern and Ayub, Atiqah and You, Hui Wen and Tan, Chai Xian and Loh, Kenneth Jia Juin and Eng, Carolyn Chai Hui and Sia, Leng Cheng and Wong, Chee Kuan (2024) High-dose pulse methylprednisolone vs. dexamethasone standard therapy for severe and critical COVID-19 pneumonia: Efficacy assessment in a retrospective single-centre experience from Malaysia. Medical Journal of Malaysia, 79 (1). 15 – 20. ISSN 0300-5283,
Full text not available from this repository.Abstract
Introduction: The use of dexamethasone (DXM) has been associated with decreased mortality in the patients with hypoxemia during the coronavirus disease-2019 (COVID-19) pandemic, while the outcomes with methylprednisolone (MTP) have been mixed. This real-life study aimed to evaluate the outcomes of patients with severe respiratory failure due to COVID-19 who were treated with high doses of MTP. Materials and Methods: This retrospective cohort study enrolled hospitalised patients between May 2021 and August 2021, aged 18 years and above, with severe respiratory failure defined by a ratio of oxygen saturation to fraction of inspired oxygen (SF ratio) of less than 235. The treatment protocol involved administering high-dose MTP for 3 days, followed by DXM, and the outcomes were compared with those of patients who received DXM alone (total treatment duration of 10 days for both groups). Results: A total of 99 patients were enrolled, with 79 (79.8) receiving pulse MTP therapy and 20 (20.2) being treated with DXM only. The SF ratio significantly improved from a mean of 144.49 (±45.16) at baseline to 208 (±85.19) at 72 hours (p < 0.05), with a mean difference of 63.51 (p < 0.001) in patients who received ≤750 mg of MTP. Additionally, in patients who received >750 mg of MTP, the SF ratio improved from a baseline mean of 130.39 (±34.53) to 208.44 (±86.61) at 72 hours (p < 0.05), with a mean difference of 78.05 (p = 0.001). In contrast, patients who received DXM only demonstrated an SF ratio of 132.85 (±44.1) at baseline, which changed minimally to 133.35 (±44.4) at 72 hours (p = 0.33), with a mean difference of 0.50 (p = 0.972). The incidence of nosocomial infection was higher in the MTP group compared with the DXM group (40.5 vs. 35, p = 0.653), with a relative risk of 1.16 (95 CI: 0.60-2.23). Conclusion: MTP did not demonstrate a significant reduction in intubation or intensive care unit admissions. Although a high dose of MTP improved gas exchange in patients with severe and critical COVID-19, it did not provide an overall mortality benefit compared to standard treatment. © 2024, Malaysian Medical Association. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Acute respiratory distress syndrome; cCrticosteroids; COVID-19; Pneumonia; Respiratory failure |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 29 Apr 2024 04:28 |
| Last Modified: | 29 Apr 2024 04:28 |
| URI: | http://eprints.um.edu.my/id/eprint/44953 |
Actions (login required)
 |
View Item |
