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10.1111/eci.13458

http://scihub22266oqcxt.onion/10.1111/eci.13458
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33219551!7744876!33219551
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suck abstract from ncbi


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pmid33219551      Eur+J+Clin+Invest 2021 ; 51 (2): e13458
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  • High-dose methylprednisolone in nonintubated patients with severe COVID-19 pneumonia #MMPMID33219551
  • Papamanoli A; Yoo J; Grewal P; Predun W; Hotelling J; Jacob R; Mojahedi A; Skopicki HA; Mansour M; Marcos LA; Kalogeropoulos AP
  • Eur J Clin Invest 2021[Feb]; 51 (2): e13458 PMID33219551show ga
  • BACKGROUND: Recent trials with dexamethasone and hydrocortisone have demonstrated benefit in patients with coronavirus disease 2019 (COVID-19). Data on methylprednisolone are limited. METHODS: Retrospective cohort of consecutive adults with severe COVID-19 pneumonia on high-flow oxygen (FiO(2) >/= 50%) admitted to an academic centre in New York, from 1 March to 15 April 2020. We used inverse probability of treatment weights to estimate the effect of methylprednisolone on clinical outcomes and intensive care resource utilization. RESULTS: Of 447 patients, 153 (34.2%) received methylprednisolone and 294 (65.8%) received no corticosteroids. At 28 days, 102 patients (22.8%) had died and 115 (25.7%) received mechanical ventilation. In weighted analyses, risk for death or mechanical ventilation was 37% lower with methylprednisolone (hazard ratio 0.63; 95% CI 0.47-0.86; P = .003), driven by less frequent mechanical ventilation (subhazard ratio 0.56; 95% CI 0.40-0.79; P = .001); mortality did not differ between groups. The methylprednisolone group had 2.8 more ventilator-free days (95% CI 0.5-5.1; P = .017) and 2.6 more intensive care-free days (95% CI 0.2-4.9; P = .033) during the first 28 days. Complication rates were not higher with methylprednisolone. CONCLUSIONS: In nonintubated patients with severe COVID-19 pneumonia, methylprednisolone was associated with reduced need for mechanical ventilation and less-intensive care resource utilization without excess complications.
  • |*Continuous Positive Airway Pressure[MESH]
  • |*Oxygen Inhalation Therapy[MESH]
  • |Aged[MESH]
  • |Bacteremia/epidemiology[MESH]
  • |COVID-19 Drug Treatment[MESH]
  • |COVID-19/mortality/physiopathology/*therapy[MESH]
  • |Female[MESH]
  • |Gastrointestinal Hemorrhage/epidemiology[MESH]
  • |Glucocorticoids/*administration & dosage[MESH]
  • |Healthcare-Associated Pneumonia/epidemiology[MESH]
  • |Humans[MESH]
  • |Intensive Care Units/*statistics & numerical data[MESH]
  • |Length of Stay[MESH]
  • |Male[MESH]
  • |Methylprednisolone/*administration & dosage[MESH]
  • |Middle Aged[MESH]
  • |Pneumonia, Ventilator-Associated/epidemiology[MESH]
  • |Proportional Hazards Models[MESH]
  • |Respiration, Artificial/*statistics & numerical data[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]


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