tetano
Editor, Senior Moderator
Syst Rev
. 2025 Nov 18;14(1):228.
doi: 10.1186/s13643-025-02976-z. Methylprednisolone versus dexamethasone in hospitalized patients with severe COVID-19: a systematic review and meta-analysis of randomized controlled trials
Jinlv Qin[SUP] 1 [/SUP], Guizuo Wang[SUP] 2 [/SUP], Dong Han[SUP] 3 [/SUP]
Affiliations
Background: The aim of this systematic review was to compare the efficacy of methylprednisolone and dexamethasone in severe COVID-19 hospitalized patients.
Methods: We conducted systematic searches of MEDLINE, Embase, the Cochrane Library, and clinicaltrials.gov without language restrictions. Randomized controlled trials (RCTs) on the treatment of severe COVID-19 with methylprednisolone, compared with dexamethasone, were included. Findings were summarized as risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorized as "high," "moderate," "low," or "very low" quality.
Results: Five RCTs (enrolling 1102 participants) met the inclusion criteria. There was no statistically significant difference in 28-day mortality (RR 0.81, 95% CI 0.58 to 1.14; GRADE = high), length of hospital stay (MD 0.67 days, 95% CI -1.77 to 3.10 days; moderate), intensive care unit (ICU) admission (RR 1.20, 95% CI 0.85 to 1.69; high), and invasive ventilation (RR 0.87, 95% CI 0.42 to 1.79; high) between the two groups. Overall, using the GRADE framework, 3 pooled analyses were rated as high quality, with 1 rated as moderate quality.
Conclusions: Methylprednisolone demonstrated similar therapeutic effects compared to dexamethasone in hospitalized patients with severe COVID-19.
Keywords: COVID-19; Dexamethasone; Meta-analysis; Methylprednisolone.
. 2025 Nov 18;14(1):228.
doi: 10.1186/s13643-025-02976-z. Methylprednisolone versus dexamethasone in hospitalized patients with severe COVID-19: a systematic review and meta-analysis of randomized controlled trials
Jinlv Qin[SUP] 1 [/SUP], Guizuo Wang[SUP] 2 [/SUP], Dong Han[SUP] 3 [/SUP]
Affiliations
- PMID: 41254702
- DOI: 10.1186/s13643-025-02976-z
Background: The aim of this systematic review was to compare the efficacy of methylprednisolone and dexamethasone in severe COVID-19 hospitalized patients.
Methods: We conducted systematic searches of MEDLINE, Embase, the Cochrane Library, and clinicaltrials.gov without language restrictions. Randomized controlled trials (RCTs) on the treatment of severe COVID-19 with methylprednisolone, compared with dexamethasone, were included. Findings were summarized as risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorized as "high," "moderate," "low," or "very low" quality.
Results: Five RCTs (enrolling 1102 participants) met the inclusion criteria. There was no statistically significant difference in 28-day mortality (RR 0.81, 95% CI 0.58 to 1.14; GRADE = high), length of hospital stay (MD 0.67 days, 95% CI -1.77 to 3.10 days; moderate), intensive care unit (ICU) admission (RR 1.20, 95% CI 0.85 to 1.69; high), and invasive ventilation (RR 0.87, 95% CI 0.42 to 1.79; high) between the two groups. Overall, using the GRADE framework, 3 pooled analyses were rated as high quality, with 1 rated as moderate quality.
Conclusions: Methylprednisolone demonstrated similar therapeutic effects compared to dexamethasone in hospitalized patients with severe COVID-19.
Keywords: COVID-19; Dexamethasone; Meta-analysis; Methylprednisolone.