Retrospective Comparison of Hospital Outcomes among Mechanically Ventilated COVID-19 Patients in ICU Who Received Methylprednisolone or Dexamethasone

SPG biomed Pub Date : 2023-04-10 DOI:10.3390/biomed3020020
Mariangela Canaan, Kelsey N. Williams, Md Ashfaq Ahmed, Zhenwei Zhang, Venkataraghavan Ramamoorthy, P. McGranaghan, M. Rubens, A. Saxena
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Abstract

Background: A number of corticosteroids are commonly used to treat COVID-19 infection. The aim of this retrospective study was to compare various hospital outcomes among mechanically ventilated COVID-19 patients in an ICU, who were administered either dexamethasone or methylprednisolone. Methods: A total of 121 mechanically ventilated COVID-19 patients from the ICU were included in the analysis, of which 43.8% (n = 53) received methylprednisolone, while 56.2% (n = 68) received dexamethasone. Results: In-hospital mortality (p = 0.381) and hospital length of stay (p = 0.307) were lower among the methylprednisolone group, compared to the dexamethasone group, though not significantly. Survival analysis showed that there were no significant differences between the methylprednisolone and dexamethasone groups (p = 0.978). A Cox proportional regression analysis showed that in-hospital mortality was lower among COVID-19 patients receiving methylprednisolone, compared to the dexamethasone group, though not significantly (hazard ratio (HR), 0.64; 95% CI: 0.35–3.17). Conclusion: Our study showed that in-hospital mortality was lower and hospital length of stay was higher among COVID-19 patients receiving methylprednisolone, compared to dexamethasone. These findings could have been due to the small sample size and limited scope of the study. Therefore, future large-scale studies should evaluate and confirm the findings in this study.
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重症监护病房机械通气患者接受甲泼尼龙与地塞米松治疗的住院疗效回顾性比较
背景:许多皮质类固醇通常用于治疗COVID-19感染。本回顾性研究的目的是比较ICU机械通气的COVID-19患者的各种医院结局,这些患者使用地塞米松或甲基强的松龙。方法:将121例ICU机械通气的COVID-19患者纳入分析,其中使用甲基强的松龙的占43.8% (n = 53),使用地塞米松的占56.2% (n = 68)。结果:甲强的松龙组住院死亡率(p = 0.381)和住院时间(p = 0.307)低于地塞米松组,但差异不显著。生存分析显示甲基强的松龙组与地塞米松组间差异无统计学意义(p = 0.978)。Cox比例回归分析显示,与地塞米松组相比,接受甲基强的松龙治疗的COVID-19患者住院死亡率较低,但差异不显著(风险比(HR), 0.64;95% ci: 0.35-3.17)。结论:我们的研究表明,与地塞米松相比,甲基强的松龙治疗的COVID-19患者住院死亡率更低,住院时间更长。这些发现可能是由于样本量小,研究范围有限。因此,未来的大规模研究应评估和确认本研究的发现。
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