METHYLPREDNISOLONE VS. DEXAMETHASONE IN THE TREATMENT OF HYPOXIC COVID-19 PNEUMONIA
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Keywords
Methylprednisolone, Dexamethasone, COVID-19, Hypoxia, Steroids
Abstract
BACKGROUND
There has been an on-going debate regarding the choice of the glucocorticoid to be used when treating moderate and severe Corona Viral Disease 2019 (COVID-19) disease. This study attempted to determine the difference in the response to Methylprednisolone vs. Dexamethasone in these patients.
METHODS
This retrospective study aimed to compare the changes produced by Methylprednisolone vs. Dexamethasone on peripheral oxygen saturation (SpO2) and four serum inflammatory markers namely C-reactive protein (CRP), Ferritin, lactate dehydrogenase (LDH) and D-dimer values after 5 days of administration.
RESULTS
The medical records of 81 patients who received Methylprednisolone and 41 who received Dexamethasone were analysed. It was seen that the improvement in the Methylprednisolone and Dexamethasone groups with respect to their SpO2, CRP, Ferritin and LDH were both significant after 5 days of therapy. Though the reduction in D-dimer was statistically significant in the Methylprednisolone group, it was not in the Dexamethasone group. The improvement in SpO2 was higher in those who received Methylprednisolone (7.42 ± 3.49 % vs. 4.88 ± 2.98; p = 0.001) but the changes in the other parameters in both groups were similar.
CONCLUSION
Although both glucocorticoids produce beneficial effects when used in moderate and severe COVID-19 disease, Methylprednisolone may be more effective in improving the hypoxia in comparison to Dexamethasone.
References
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Dr. Rajesh Patil
Junior Resident, Department of General Medicine, Ramaiah Medical College, Bangalore, Karnataka, India.
Dr. Akshay Rao
Associate Professor, Department of General Medicine, Ramaiah Medical College, Bangalore, Karnataka, India