High Dose Methylprednisolone Bests Dexamethasone For Hospita
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Methylprednisolone is better than dexamethasone for the treatment of hospitalized patients with severe Covid-19 Pneumonia, according to a recent study. The study found that the treatment with high-dose methylprednisolone for three days followed by oral prednisone for 14 days versus 6 mg dexamethasone for 7 to 10 days significantly decreased the need for transfer to ICU, recovery time, and the severity markers C-reactive protein (CRP), D-dimer and LDH.

The researchers conducted an ambispective cohort study with survival analysis of patients diagnosed with severe Covid-19 pneumonia. The patients should also have supplementary oxygen and radiological confirmation of Pneumonia by chest tomography. 111 patients were treated with the institutional protocol with intravenous dexamethasone 6 mg QD for seven to 10 days if they required oxygen.

Since September 15, 2020, the hospitalization protocol of the clinic was modified by the Infectious Diseases and Pulmonology service, recommending a high dose of methylprednisolone of 250 to 500 mg every day for three days with a subsequent change to oral prednisone 50 mg every day for 14 days. Follow-up was carried out by outpatient consultation one month after discharge or by telephone, inquiring about readmission or living-dead status.

~ Key findings of the study include:
• 216 patients had Covid-19 pneumonia documented by ground-glass imaging and alveolar pressure / inspired oxygen fraction (PaFi) less than 300. 111 patients received dexamethasone (DXM) and 105 received methylprednisolone (MTP).

• Patients in the DXM group evolved to severe ARDS in a higher proportion.

• Upon completion 4 days of treatment with parenteral corticosteroid, laboratory markers of severity decreased significantly in the group that received MTP, CRP 2.85 vs 7.2, D-dimer 691 vs 1083 and DHL 273 vs 355.

• After starting the corticosteroid, transfer to the intensive care unit and mortality was lower in the group that received MTP.

• Recovery time was shorter in patients treated with MTP, three days vs. DXM 6 days.

• At 30-day follow-up, 92.6% were alive in MTP vs 63.1% of those who received dexamethasone.

Randomized controlled studies with methylprednisolone are required to corroborate its effect, and studies in a population hospitalized in intensive care wards, wrote the authors.

Source:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252057
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Dr. S●●●●p N●●h
Dr. S●●●●p N●●h Internal Medicine
Well being a physician, during this 2nd wave I have treated about 100 in-hospital COVID patients and with that personal experience I 2nd the study data.
Jun 3, 2021Like