Аутор и коаутори: Peđa Kovačević, Jovana Malić, Tijana Kovačević, Saša Dragić, Biljana Zlojutro, Milka Jandrić, Danica Momčičević, Branka Čančarević - Đajić, Ranko Škrbić, M. Zeeshan Rizwan

Comparative efficacy of high – dose dexamethasone versus methylprednisolone in coronavirus disease 2019 ( COVID – 19 ) – associated acute respiratory distress syndrome

Година објаве: 2024

Језик: Енглески


Objective: This retrospective (matched paired) clinical trial aimed to compare the efficacy of dexamethasone vs. methylprednisolone at equipotent (high) doses in patients with coronavirus disease 2019 (COVID-19)- associated acute respiratory distress syndrome (ARDS). Methods: A total of 347 patients with moderate and severe COVID-19-associated ARDS were administered either a high (equipotent) dose of dexamethasone (32 mg) or methylprednisolone (180 mg) for a duration of up to 10 days. All participants received the standard of care for critically ill COVID-19 patients. Results: The primary outcomes included length of stay in the ICU, ICU mortality, and discharge from the hospital. Based on the obtained results, a tendency towards more favorable clinical outcomes concerning the length of stay in the ICU (in the group of patients treated with non-invasive mechanical ventilation (NIV), p<0.05), ICU mortality, and discharge from the hospital (in the group of patients who were intubated, p<0.05) in patients receiving the high dose of dexamethasone compared to those receiving methylprednisolone was observed. Conclusion: It appears that severe cases of COVID-19, especially intubated ones, treated with high doses of dexamethasone have a more favorable clinical outcome than the use of equipotent doses of methylprednisolone. However, larger multicenter studies are needed to validate our observations.