학술논문
Safety and efficacy of methylprednisolone dexamethasone in critically ill patients with COVID-19 acute respiratory distress syndrome: a retrospective study
Document Type
article
Author
Source
Therapeutic Advances in Infectious Disease, Vol 10 (2023)
Subject
Language
English
ISSN
2049-937X
20499361
20499361
Abstract
Background: Corticosteroids (CSs), specifically dexamethasone (DEX), are the treatment of choice for severe acute respiratory distress syndrome (ARDS) due to COVID-19 pneumonia (CARDS). However, data from both ARDS and relatively small CARDS clinical trials have suggested improved outcomes with methylprednisolone (MP) versus DEX. The objective of this retrospective cohort study was to compare the safety and effectiveness of MP and DEX in critically ill CARDS patients. Methods: The study cohort included CARDS patients admitted to a tertiary referral intensive care unit (ICU) between April and September 2020 who received at least 5 days of CSs for CARDS. Results: The cohort was notable for a high severity of illness (overall, 88.5% of patients required mechanical ventilation and 16% required vasopressors on admission). The DEX group ( n = 62) was significantly older with a higher illness severity [Sequential Organ Failure Assessment (SOFA) 6 (4.75–8) versus 4.5 (3–7), p = 0.008], while the MP group ( n = 51) received significantly more loading doses [19 (37.3%) versus 4 (6.5%), p