Different Dose Corticosteroid Treatment Protocols for COVID-19 Patients Admitted to Intensive Care: Comparison of the Effects on Efficacy and Mortality

Abstract

Aim: In the present study, our purpose was to evaluate the efficacy of the pulse-steroid treatment used in COVID-19 associated severe ARDS patients, and also to identify its effects on mortality in different doses. Study design: Retrospective Study Method: Patients with severe COVID-19 associated ARDS who had not previously received steroids, but were administered 1 g methylprednisolone (group 1) or 250 mg methylprednisolone (group 2) for 3 days, then 1 mg/kg/day during their hospitalization were retrospectively analyzed. The primary end-point was the discharge rate from the ICU or death. The secondary end-point was the 15th day survival rate. Result(s): A total of 48 patients with a mean age of 70.96+/-11.04 years were included. Twenty-six (54.2%) of them were male, 22 (45.8%) were female. Group 1 included 21 patients, group 2 included 27 patients. There was no difference in terms of demographic characteristics, comorbidities present, and medical findings between the groups on admission, except for the ferritin value which was lower in group 2 (p=0.027). There was no significant difference between groups groups in the 15-day mortality (p=0.134) and length of ICU stay (p=0.329). There was no difference between the groups in terms of discharge rates (p=0.55), need for mechanical ventilation (p=0.381), and complications (p=0.784). The odds ratio regarding the mortality of the patients in the 1 g pulse-steroid group was 3.17 times more likely than the 250 mg pulse-steroid group. Conclusion(s): Our results support that pulse-steroid therapy with 250 mg methylprednisolone may be more effective in patients admitted to intensive care units with ARDS due to COVID-19. Copyright © 2022 by Society of Turkish Intensivist.