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Aljuhani, Ohoud, Korayem, Ghazwa B., Altebainawi, Ali F., AlMohammady, Daniah, Alfahed, Amjaad, Altebainawi, Elaf F., Aldhaeefi, Mohammed, Badreldin, Hisham A., Vishwakarma, Ramesh 
ORCID: https://orcid.org/0000-0003-2458-2802, Almutairi, Faisal E., Alenazi, Abeer A., Alsulaiman, Thamer, Alqahtani, Rahaf Ali, Al Dhahri, Fahad, Aldardeer, Namareq, Alenazi, Ahmed O., Al Harbi, Shmeylan, Kensara, Raed, Alalawi, Mai and Al Sulaiman, Khalid
(2024)
Dexamethasone versus methylprednisolone for multiple organ dysfunction in COVID-19 critically ill patients: A multicenter propensity score matching study.
BMC Infectious Diseases, 24.
ISSN 1471-2334
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Abstract
Background: Dexamethasone usually recommended for patients with severe coronavirus disease 2019 (COVID-19) to reduce short-term mortality. However, it is uncertain if another corticosteroid, such as methylprednisolone, may be utilized to obtain better clinical outcome. This study assessed dexamethasone’s clinical and safety outcomes compared to methylprednisolone. Methods: A multicenter, retrospective cohort study was conducted between March 01, 2020, and July 31, 2021. It included adult COVID-19 patients who were initiated on either dexamethasone or methylprednisolone therapy within 24 h of intensive care unit (ICU) admission. The primary outcome was the progression of multiple organ dysfunction score (MODS) on day three of ICU admission. Propensity score (PS) matching was used (1:3 ratio) based on the patient’s age and MODS within 24 h of ICU admission. Results: After Propensity Score (PS) matching, 264 patients were included; 198 received dexamethasone, while 66 patients received methylprednisolone within 24 h of ICU admission. In regression analysis, patients who received methylprednisolone had a higher MODS on day three of ICU admission than those who received dexamethasone (beta coefficient: 0.17 (95% CI 0.02, 0.32), P = 0.03). Moreover, hospital-acquired infection was higher in the methylprednisolone group (OR 2.17, 95% CI 1.01, 4.66; p = 0.04). On the other hand, the 30-day and the in-hospital mortality were not statistically significant different between the two groups. Conclusion: Dexamethasone showed a lower MODS on day three of ICU admission compared to methylprednisolone, with no statistically significant difference in mortality.
| Item Type: | Article |
|---|---|
| Additional Information: | Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Funding information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
| Uncontrolled Keywords: | 30-day mortality,covid-19,critically ill,dexamethasone,icus,in-hospital mortality,methylprednisolone,sars-cov-2,ventilation free days (vfds),infectious diseases,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2725 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 22 Nov 2024 09:30 |
| Last Modified: | 27 Nov 2024 10:46 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97749 |
| DOI: | 10.1186/s12879-024-09056-y |
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