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Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial.
Ranjbar, Keivan; Moghadami, Mohsen; Mirahmadizadeh, Alireza; Fallahi, Mohammad Javad; Khaloo, Vahid; Shahriarirad, Reza; Erfani, Amirhossein; Khodamoradi, Zohre; Gholampoor Saadi, Mohammad Hasan.
  • Ranjbar K; Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Moghadami M; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Mirahmadizadeh A; Health Policy research center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran. moghadami@sums.ac.ir.
  • Fallahi MJ; Health Policy research center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Khaloo V; Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Shahriarirad R; Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Erfani A; Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Khodamoradi Z; Ali Asghar hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
  • Gholampoor Saadi MH; Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Infect Dis ; 21(1): 337, 2021 04 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1175297
ABSTRACT

BACKGROUND:

Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients.

METHODS:

In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8).

RESULTS:

There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040).

CONCLUSION:

In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. TRIAL REGISTRATION The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1 ).
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Dexametasona / Metilprednisolona / Tratamiento Farmacológico de COVID-19 Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Tópicos: Vacunas Límite: Adulto / Anciano / Femenino / Humanos / Masculino / Middle aged País/Región como asunto: Asia Idioma: Inglés Revista: BMC Infect Dis Asunto de la revista: Enfermedades Transmisibles Año: 2021 Tipo del documento: Artículo País de afiliación: S12879-021-06045-3

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Dexametasona / Metilprednisolona / Tratamiento Farmacológico de COVID-19 Tipo de estudio: Estudio de cohorte / Estudio experimental / Estudio observacional / Estudio pronóstico / Ensayo controlado aleatorizado Tópicos: Vacunas Límite: Adulto / Anciano / Femenino / Humanos / Masculino / Middle aged País/Región como asunto: Asia Idioma: Inglés Revista: BMC Infect Dis Asunto de la revista: Enfermedades Transmisibles Año: 2021 Tipo del documento: Artículo País de afiliación: S12879-021-06045-3