Impact of Methylprednisolone Pulse on the Mortality of Patients With Acute Respiratory Distress Syndrome Secondary to COVID-19

Abstract

Introduction Corticosteroids have been thoroughly used in the treatment of COVID-19. The aim of the study was to analyze the impact of methylprednisolone pulse on in-hospital mortality of patients with acute respiratory distress syndrome (ARDS) due to COVID-19. Methods We conducted a retrospective, single-center observational study. We selected adult patients admitted to the hospital with the diagnosis of COVID-19 between March and June 2020. Cox regression was used to identify the factors associated with in-hospital mortality. Results A total of 306 patients were analyzed. In-hospital crude mortality rate was 17%. Diabetes mellitus (hazard ratio [HR], 5.5; 95% confidence interval [CI], 1.40–4.55), dementia (HR, 7.7; 95% CI, 4.25–13.87) and ARDS (HR, 4.2; 95% CI, 2.34–7.46) were associated with in-hospital mortality. In patients with ARDS diagnosis, the only in-hospital mortality risk factor was dementia (HR, 5.2; 95% CI, 2.44–11.07), whereas methylprednisolone pulse was a protective factor (HR, 0.2; 95% CI, 0.09–0.63). In the follow-up, 40% of patients had some symptom related to COVID-19. Conclusions Methylprednisolone pulse reduced the in-hospital mortality in patients with ARDS due to COVID-19. A high percentage of patients presented persistent symptoms in 90 days after the hospital discharge.