tetano
Editor, Senior Moderator
J Pharm Policy Pract
. 2024 Apr 17;17(1):2337125.
doi: 10.1080/20523211.2024.2337125. eCollection 2024. Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study
Nur Fatin Najwa Azemi[SUP] 1 2 [/SUP], Farida Islahudin[SUP] 1 [/SUP], Rahela Ambaras Khan[SUP] 2 [/SUP], Shamin Mohd Saffian[SUP] 1 [/SUP], Leong Chee Loon[SUP] 2 [/SUP]
Affiliations
Introduction: Trials have demonstrated the benefits of methylprednisolone in the treatment of coronavirus disease 2019 (COVID-19). However, data on optimal dose, duration and timing of administration are limited. This study investigates the outcome of various methylprednisolone treatment regimens among hospitalised COVID-19 patients.
Methods: A retrospective cohort study was conducted on hospitalised adult COVID-19 patients admitted between June and August 2021 in general COVID-19 wards, treated with methylprednisolone. Clinical outcomes evaluated include in-hospital mortality, thirty-day mortality, clinical efficacy (C-reactive protein (CRP), total white blood cells (TWBC) and oxygen requirement) as well as the safety of methylprednisolone.
Results: Of 278 patients, 1(0.4%) received weight-based dosing of 1 mg/kg/day, 101(36.3%) received weight-based dosing of 2 mg/kg/day, 130(46.8%) received fixed dosing methylprednisolone 250 mg/day and 46(16.5%) received fixed dosing methylprednisolone 500 mg/day. There was a significant difference in in-hospital mortality rates following different methylprednisolone doses whereby in-hospital mortality occurred in 22.5% (n = 23) of patients with 1 or 2 mg/kg/day methylprednisolone, 32.3% (n = 42) with 250 mg/day and 39.1% (n = 18) with 500 mg/day (p = 0.023). On the other hand, no significant difference in thirty-day mortality, clinical efficacy and safety was observed between different dosing regimens (p > 0.05).
Conclusion: The use of methylprednisolone weight-based dosing in hospitalised COVID-19 patients should be considered due to the positive outcome associated with lower in-hospital mortality.
Keywords: COVID-19; Methylprednisolone; mortality; outcome.
. 2024 Apr 17;17(1):2337125.
doi: 10.1080/20523211.2024.2337125. eCollection 2024. Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study
Nur Fatin Najwa Azemi[SUP] 1 2 [/SUP], Farida Islahudin[SUP] 1 [/SUP], Rahela Ambaras Khan[SUP] 2 [/SUP], Shamin Mohd Saffian[SUP] 1 [/SUP], Leong Chee Loon[SUP] 2 [/SUP]
Affiliations
- PMID: 38638422
- PMCID: PMC11025403
- DOI: 10.1080/20523211.2024.2337125
Introduction: Trials have demonstrated the benefits of methylprednisolone in the treatment of coronavirus disease 2019 (COVID-19). However, data on optimal dose, duration and timing of administration are limited. This study investigates the outcome of various methylprednisolone treatment regimens among hospitalised COVID-19 patients.
Methods: A retrospective cohort study was conducted on hospitalised adult COVID-19 patients admitted between June and August 2021 in general COVID-19 wards, treated with methylprednisolone. Clinical outcomes evaluated include in-hospital mortality, thirty-day mortality, clinical efficacy (C-reactive protein (CRP), total white blood cells (TWBC) and oxygen requirement) as well as the safety of methylprednisolone.
Results: Of 278 patients, 1(0.4%) received weight-based dosing of 1 mg/kg/day, 101(36.3%) received weight-based dosing of 2 mg/kg/day, 130(46.8%) received fixed dosing methylprednisolone 250 mg/day and 46(16.5%) received fixed dosing methylprednisolone 500 mg/day. There was a significant difference in in-hospital mortality rates following different methylprednisolone doses whereby in-hospital mortality occurred in 22.5% (n = 23) of patients with 1 or 2 mg/kg/day methylprednisolone, 32.3% (n = 42) with 250 mg/day and 39.1% (n = 18) with 500 mg/day (p = 0.023). On the other hand, no significant difference in thirty-day mortality, clinical efficacy and safety was observed between different dosing regimens (p > 0.05).
Conclusion: The use of methylprednisolone weight-based dosing in hospitalised COVID-19 patients should be considered due to the positive outcome associated with lower in-hospital mortality.
Keywords: COVID-19; Methylprednisolone; mortality; outcome.