Clinical Outcomes Associated With Methylprednisolone in Mechanically Ventilated Patients With COVID-19.
Clin Infect Dis
; 72(9): e367-e372, 2021 05 04.
Article
in English
| MEDLINE | ID: covidwho-696354
ABSTRACT
BACKGROUND:
The efficacy and safety of methylprednisolone in mechanically ventilated patients with acute respiratory distress syndrome resulting from coronavirus disease 2019 (COVID-19) are unclear. In this study, we evaluated the association between use of methylprednisolone and key clinical outcomes.METHODS:
Clinical outcomes associated with the use of methylprednisolone were assessed in an unmatched, case-control study; a subset of patients also underwent propensity-score matching. Patients were admitted between 1 March and 12 April, 2020. The primary outcome was ventilator-free days by 28 days after admission. Secondary outcomes included extubation, mortality, discharge, positive cultures, and hyperglycemia.RESULTS:
A total of 117 patients met inclusion criteria. Propensity matching yielded a cohort of 42 well-matched pairs. Groups were similar except for hydroxychloroquine and azithromycin use, which were more common in patients who did not receive methylprednisolone. Mean ventilator-free days were significantly higher in patients treated with methylprednisolone (6.21â ±â 7.45 vs 3.14â ±â 6.22; Pâ =â .044). The probability of extubation was also increased in patients receiving methylprednisolone (45% vs 21%; Pâ =â .021), and there were no significant differences in mortality (19% vs 36%; Pâ =â .087). In a multivariable linear regression analysis, only methylprednisolone use was associated with a higher number of ventilator-free days (Pâ =â .045). The incidence of positive cultures and hyperglycemia were similar between groups.CONCLUSIONS:
Methylprednisolone was associated with increased ventilator-free days and higher probability of extubation in a propensity-score matched cohort. Randomized, controlled studies are needed to further define methylprednisolone use in patients with COVID-19.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Methylprednisolone
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Clin Infect Dis
Journal subject:
Communicable Diseases
Year:
2021
Document Type:
Article
Affiliation country:
Cid
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