Patients with severe coronavirus disease 2019 (COVID-19) pneumonia had improved prognosis after receiving a short course of methyl-prednisolone pulses during the second week of disease, according to study results published in PLoS One.
Clinical end points of time to death and time to endotracheal intubation were monitored in patients with severe COVID-19 pneumonia. Comparisons were made between patients who received a short course of methyl-prednisolone pulses during the second week of disease and those who only received standard care. Methyl-prednisolone pulses were defined as 125 to 250 mg per day for 3 consecutive days.
Of the 242 patients with COVID-19 pneumonia and elevated inflammatory markers, 22 patients died, and 31 either died or received intubation. A total of 61 patients received methyl-prednisolone pulses during the second week of disease. The adjusted hazard ratios for death and death or intubation for patients in the week 2 methyl-prednisolone group were 0.35 (P =.064) and 0.33 (P =.020), respectively.
“This study confirms that [methyl-prednisolone], 125-250 mg/d for 3 consecutive days given during the second week of disease without subsequent tapering, improve the prognosis of patients with COVID-19 pneumonia, features of inflammatory activity and respiratory deterioration,” the study authors wrote. “Our results open the door to a more rational and planned management of patients with COVID-19.”
Ruiz-Irastorza G, Pijoan J-I, Bereciartua E, et al; on behalf of the Cruces COVID Study Group. Second week methyl-prednisolone pulses improve prognosis in patients with severe coronavirus disease 2019 pneumonia: an observational comparative study using routine care data. PLoS One. Published online September 22, 2020. doi:10.1371/journal.pone.0239401