High-Dose or Low-Dose Corticosteroids - Which Regimen is More Effective in Patients with Moderate to Severe COVID-19? A Retrospective Study.

Abstract

Background: Although several studies have assessed corticosteroid therapy as a pivotal treatment for SARS-CoV-2, the net effectiveness of corticosteroids in the treatment of COVID-19 remains controversial. This study aimed to compare the conventional use of methylprednisolone and pulse therapy to determine the best method of administration of corticosteroids in patients with SARS-CoV-2.

Methods: A total of 52 patients with a diagnosis of moderate to severe COVID-19 with the same conditions were retrospectively enrolled in the present study. Participants were divided into two groups based on the corticosteroid therapy regimen received during hospitalization: low-dose and high-dose methylprednisolone. Clinical outcomes, including laboratory tests, improvement of oxygen saturation, the need for invasive mechanical ventilation, length of hospital stay (LOHS) and mortality, were compared between the two groups.

Results: The distribution of sex, age, oxygen saturation on admission, pattern and location of lung involvement, and other medical conditions were similar between the two groups to avoid the effect of any possible confounding factor. There were no differences in laboratory tests (P=0.389), LOHS (P=0.107), improvement of oxygen saturation (P=0.721), the need for invasive mechanical ventilation and mortality (P=0.695) between groups.

Conclusion: Based on the results of this study, there was no significant difference in clinical outcomes of patients with COVID-19 between low- and high-dose corticosteroid regimens. Further research is warranted to determine the best method of administration of corticosteroids in these patients.