Clinical outcomes of patients treated with dexamethasone vs. methylprednisolone for severe COVID-19 pneumonia

ABSTRACT

BACKGROUND: Coronavirus Disease 19 (COVID-19) damages the lungs and may potentially culminate in acute respiratory distress syndrome (ARDS). Several therapy strategies, including corticosteroids, have been attempted across the world with favorable results. However, the most suitable corticosteroid type and dose for COVID-19 treatment remain undefined. Therefore, we performed a study to retrospectively compare the efficacy of two popular corticosteroid therapies dexamethasone and methylprednisolone, in treating severe COVID-19 pneumonia. METHODS: This observational retrospective cohort analysis comprised 1001 patients diagnosed with an established diagnosis of severe COVID-19 pneumonia who were hospitalized to a tertiary care hospital, Dr. Ziauddin Hospital North Nazimabad, Karachi, Pakistan, from April 2020 through February 2021. RESULTS: Between the two study groups, no significant difference was reported in patient mortality. A significantly higher percentage of MTP patients required admission to the ICU (194 (33.0%) vs. 89 (21.5%);P- < 0.001). Patients in the DXM group had significantly lower chances of being admitted to the ICU (OR 0.419, 95% CI 0.273-0.642;P- < 0.001), supported by a significantly lower risk of the need of ICU admission (HR 0.538, 95% CI 0.383-0.755;P- < 0.001). Additionally, on Kaplan-Meier analysis, the DXM group patients received discharge from the hospital significantly earlier (6.83 vs. 8.20 days;Log Rank P-0.003) and required ICU admission much later (5.01 vs. 2.40 days;Log Rank P- < 0.001). CONCLUSION: Dexamethasone was found to have a significant reduction in the need for intensive care unit admission as well as early hospital discharge.