The choice of steroids in severe-critical COVID-19 and outcome: A Retrospective Cohort Study from Northern Areas of Pakistan
DOI:
https://doi.org/10.1996/pjcm.v28i3.750Keywords:
COVID-19, Methylprednisolone, Dexamethasone, MortalityAbstract
Abstract: Background: Covid-19 revealed as global pandemic during year 2020. Until July 2021, the death toll reached 4.15 million. The Recovery trial proved mortality benefit in group of patients who were treated with dexamethasone. However, methylprednisolone has better penetration and half-life in alveoli. There are some internationally published studies showing more beneficial effects in terms of fatality for using high dose methylprednisolone in comparison to dexamethasone. The purpose of this study is to see the difference in efficacy of two steroids i.e. dexamethasone versus methylprednisolone in patients admitted in COVID-ICU Aga Khan Medical Centre Gilgit, Northern Areas of Pakistan with severe-critical COVID. Methods: The medical records of all adult patients who were admitted to the ICU at Aga Khan Medical Centre Gilgit, Northern Areas of Pakistan with severe-critical COVID 19 were reviewed from 01/09/2020 till 31/08/2021 over a period of one year. Patients taking chronic steroid therapy, those with mortality within 24 hours of admission and patients with incomplete medical record were exempted. Results: A total of 89 patients were enrolled during the study time. Along with the standard treatment, 54 patients were given dexamethasone and 27 patients were given methylprednisolone. A 3rd cohort of 8 patients receiveddexamethasone for the first two days followed by methylprednisolone. There was no significant difference between three groups in terms of demographics and clinical presentation. The overall mortality in this study was 29.2%. No statistical difference in terms of use of inotropic/ vasopressor support, assisted ventilation (invasive & non-invasive) and length of hospital stay were found. Conclusion: Dexamethasone and methylprednisolone are both equally efficacious in treatment of severe-critical covid-19 disease. Keywords: Covid-19;Methylprednisolone; Dexamethasone; Mortality.References
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