tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Apr 10;21(1):337.
doi: 10.1186/s12879-021-06045-3.
Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial
Keivan Ranjbar[SUP] 1 2 [/SUP], Mohsen Moghadami[SUP] 3 [/SUP], Alireza Mirahmadizadeh[SUP] 4 5 [/SUP], Mohammad Javad Fallahi[SUP] 1 6 [/SUP], Vahid Khaloo[SUP] 7 [/SUP], Reza Shahriarirad[SUP] 1 2 [/SUP], Amirhossein Erfani[SUP] 1 2 [/SUP], Zohre Khodamoradi[SUP] 6 8 [/SUP], Mohammad Hasan Gholampoor Saadi[SUP] 2 [/SUP]
Affiliations
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/kg/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 ).
Keywords: COVID-19; Corticosteroid; Dexamethasone; Methylprednisolone; Randomized controlled trial.
. 2021 Apr 10;21(1):337.
doi: 10.1186/s12879-021-06045-3.
Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial
Keivan Ranjbar[SUP] 1 2 [/SUP], Mohsen Moghadami[SUP] 3 [/SUP], Alireza Mirahmadizadeh[SUP] 4 5 [/SUP], Mohammad Javad Fallahi[SUP] 1 6 [/SUP], Vahid Khaloo[SUP] 7 [/SUP], Reza Shahriarirad[SUP] 1 2 [/SUP], Amirhossein Erfani[SUP] 1 2 [/SUP], Zohre Khodamoradi[SUP] 6 8 [/SUP], Mohammad Hasan Gholampoor Saadi[SUP] 2 [/SUP]
Affiliations
- PMID: 33838657
- DOI: 10.1186/s12879-021-06045-3
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/kg/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 ).
Keywords: COVID-19; Corticosteroid; Dexamethasone; Methylprednisolone; Randomized controlled trial.