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Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients

OBJECTIVE: The present study aimed to evaluate and compare the use of 2 different high-dose methylprednisolone posology in treating severe coronavirus disease 2019 pneumonia regarding mortality and recovery time between themselves and against steroidal/non-steroidal treatment. MATERIAL AND METHODS:...

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Autores principales: Eser, Fatma, Kayaaslan, Bircan, Kaya Kalem, Ayşe, Hasanoğlu, İmran, Bilgiç, Zeynep, Asiltürk, Dilek, Kaplan, Betül, Güner, Rahmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Thoracic Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652074/
https://www.ncbi.nlm.nih.gov/pubmed/37503642
http://dx.doi.org/10.5152/ThoracResPract.2023.22050
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author Eser, Fatma
Kayaaslan, Bircan
Kaya Kalem, Ayşe
Hasanoğlu, İmran
Bilgiç, Zeynep
Asiltürk, Dilek
Kaplan, Betül
Güner, Rahmet
author_facet Eser, Fatma
Kayaaslan, Bircan
Kaya Kalem, Ayşe
Hasanoğlu, İmran
Bilgiç, Zeynep
Asiltürk, Dilek
Kaplan, Betül
Güner, Rahmet
author_sort Eser, Fatma
collection PubMed
description OBJECTIVE: The present study aimed to evaluate and compare the use of 2 different high-dose methylprednisolone posology in treating severe coronavirus disease 2019 pneumonia regarding mortality and recovery time between themselves and against steroidal/non-steroidal treatment. MATERIAL AND METHODS: Severe coronavirus disease 2019 patients followed up between March 2020 and January 2021 were included. The steroid-free treatment protocol was applied before August 2020 (non-pulse group) and a treatment algorithm containing normal and high doses of methylprednisolone was applied after August 2020 (pulse group). Patients with clinical deterioration under the normal dose of methylprednisolone were administered 250 mg or 1000 mg of methylprednisolone for 3 days. We compared the pulse and non-pulse groups, in addition to pulse subgroups with each other, for clinical outcomes. RESULTS: A total of 138 patients were included, including 36 patients in the non-pulse group and 102 in the pulse group. In the pulse group, 70 patients received 1000 mg/day and 32 received 250 mg/day of high-dose methylprednisolone therapy. In the comparison of pulse and non-pulse patient groups, mortality rate was lower in the pulse group (P < .001), and the time to discharge without oxygen support was shorter. Although the patients in the 250 mg subgroup were older, there was no difference between the 250 mg and 1000 mg subgroups in terms of end of oxygen requirement, discharge with oxygen support, and mortality. In addition, the required time to reach the oxygen-free period in patients discharged without oxygen support was similar in the 2 subgroups, and the majority of patients in both subgroups reached the oxygen-free period on the 20th day after initiating methylprednisolone. CONCLUSION: Since there was no difference in clinical improvement between the use of 250 mg or 1000 mg methylprednisolone in patients with severe coronavirus disease 2019 infection, 1000 mg methylprednisolone was not required.
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spelling pubmed-106520742023-03-01 Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients Eser, Fatma Kayaaslan, Bircan Kaya Kalem, Ayşe Hasanoğlu, İmran Bilgiç, Zeynep Asiltürk, Dilek Kaplan, Betül Güner, Rahmet Thorac Res Pract Original Article OBJECTIVE: The present study aimed to evaluate and compare the use of 2 different high-dose methylprednisolone posology in treating severe coronavirus disease 2019 pneumonia regarding mortality and recovery time between themselves and against steroidal/non-steroidal treatment. MATERIAL AND METHODS: Severe coronavirus disease 2019 patients followed up between March 2020 and January 2021 were included. The steroid-free treatment protocol was applied before August 2020 (non-pulse group) and a treatment algorithm containing normal and high doses of methylprednisolone was applied after August 2020 (pulse group). Patients with clinical deterioration under the normal dose of methylprednisolone were administered 250 mg or 1000 mg of methylprednisolone for 3 days. We compared the pulse and non-pulse groups, in addition to pulse subgroups with each other, for clinical outcomes. RESULTS: A total of 138 patients were included, including 36 patients in the non-pulse group and 102 in the pulse group. In the pulse group, 70 patients received 1000 mg/day and 32 received 250 mg/day of high-dose methylprednisolone therapy. In the comparison of pulse and non-pulse patient groups, mortality rate was lower in the pulse group (P < .001), and the time to discharge without oxygen support was shorter. Although the patients in the 250 mg subgroup were older, there was no difference between the 250 mg and 1000 mg subgroups in terms of end of oxygen requirement, discharge with oxygen support, and mortality. In addition, the required time to reach the oxygen-free period in patients discharged without oxygen support was similar in the 2 subgroups, and the majority of patients in both subgroups reached the oxygen-free period on the 20th day after initiating methylprednisolone. CONCLUSION: Since there was no difference in clinical improvement between the use of 250 mg or 1000 mg methylprednisolone in patients with severe coronavirus disease 2019 infection, 1000 mg methylprednisolone was not required. Turkish Thoracic Society 2023-03-01 /pmc/articles/PMC10652074/ /pubmed/37503642 http://dx.doi.org/10.5152/ThoracResPract.2023.22050 Text en 2023 authors https://creativecommons.org/licenses/by-nc/4.0/ Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Article
Eser, Fatma
Kayaaslan, Bircan
Kaya Kalem, Ayşe
Hasanoğlu, İmran
Bilgiç, Zeynep
Asiltürk, Dilek
Kaplan, Betül
Güner, Rahmet
Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title_full Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title_fullStr Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title_full_unstemmed Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title_short Effect of 2 Different High-Dose Methylprednisolone Treatments on Clinical Outcomes in Severe COVID-19 Patients
title_sort effect of 2 different high-dose methylprednisolone treatments on clinical outcomes in severe covid-19 patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652074/
https://www.ncbi.nlm.nih.gov/pubmed/37503642
http://dx.doi.org/10.5152/ThoracResPract.2023.22050
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