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Article

A Retrospective Observational Cohort Study on the Efficacy and Safety of Methylprednisolone Pulse Therapy for COVID-19 Pneumonia

by
Kazuhiro Yokota
1,
Hisashi Noma
1,2,
Norihito Tarumoto
3,
Noriomi Ishibashi
3,
Jun Sakai
3,
Shigefumi Maesaki
3,
Shinichiro Iida
4,
Yoshitaka Uchida
5,
Takahiro Uchida
5,
Hideto Nakayama
6,
Yoshiyuki Haga
7 and
Toshihide Mimura
1,*
1
Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Iruma 350-0495, Saitama, Japan
2
Department of Data Science, The Institute of Statistical Mathematics, Tachikawa 190-8562, Tokyo, Japan
3
Department of Infectious Disease and Infection Control, Saitama Medical University, Iruma 350-0495, Saitama, Japan
4
Department of Cardiovascular Medicine, Saitama Medical University, Iruma 350-0495, Saitama, Japan
5
Department of Respiratory Medicine, Saitama Medical University, Iruma 350-0495, Saitama, Japan
6
Department of Anesthesiology, Saitama Medical University, Iruma 350-0495, Saitama, Japan
7
Department of Intensive Care Medicine, Saitama Medical University, Iruma 350-0495, Saitama, Japan
*
Author to whom correspondence should be addressed.
COVID 2022, 2(3), 244-253; https://doi.org/10.3390/covid2030019
Submission received: 27 December 2021 / Revised: 13 February 2022 / Accepted: 25 February 2022 / Published: 28 February 2022
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Abstract

Coronavirus disease 2019 (COVID-19) is associated with fatal acute respiratory distress syndrome, which can be ameliorated by methylprednisolone pulse therapy, thereby reducing the risk of progression to respiratory failure and death. We aimed to determine the efficacy and safety of methylprednisolone pulse therapy for patients with COVID-19 pneumonia. In this retrospective, observational cohort study, seventy patients (age, 35–91 years) who were admitted to Saitama Medical University Hospital in Japan between March 2020 and January 2021 due to COVID-19 pneumonia were included. The difference in mortality between the methylprednisolone pulse therapy (n = 22) and dexamethasone therapy (n = 48) groups was the primary outcome. Between-group differences in the average length of intensive care unit stay, duration of invasive mechanical ventilation, and incidence of treatment-related adverse events were the secondary outcomes. The methylprednisolone pulse therapy group showed a significantly lower mortality rate (3.8% vs. 20.2%, p = 0.006) and increased survival rate compared with the dexamethasone therapy group (p = 0.044). Additionally, without statistical significance, the average length of intensive care unit stay tended to be shorter in the methylprednisolone pulse therapy group (11.5 ± 6.1 days) than in the dexamethasone therapy group (22.3 ± 23.1 days) (p = 0.793). The average duration of invasive mechanical ventilation also tended to be shorter in the methylprednisolone pulse therapy group (15.3 ± 10.1 vs. 28.8 ± 9.2 days, p = 0.120). There were no significant differences in the incidence of treatment-related serious adverse events between the two groups. In conclusion, methylprednisolone pulse therapy for patients with COVID-19 pneumonia significantly reduced mortality and increased the survival rate compared to conventional dexamethasone therapy.
Keywords: acute respiratory distress syndrome; COVID-19; cytokine storm; dexamethasone therapy; methylprednisolone pulse therapy acute respiratory distress syndrome; COVID-19; cytokine storm; dexamethasone therapy; methylprednisolone pulse therapy

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MDPI and ACS Style

Yokota, K.; Noma, H.; Tarumoto, N.; Ishibashi, N.; Sakai, J.; Maesaki, S.; Iida, S.; Uchida, Y.; Uchida, T.; Nakayama, H.; et al. A Retrospective Observational Cohort Study on the Efficacy and Safety of Methylprednisolone Pulse Therapy for COVID-19 Pneumonia. COVID 2022, 2, 244-253. https://doi.org/10.3390/covid2030019

AMA Style

Yokota K, Noma H, Tarumoto N, Ishibashi N, Sakai J, Maesaki S, Iida S, Uchida Y, Uchida T, Nakayama H, et al. A Retrospective Observational Cohort Study on the Efficacy and Safety of Methylprednisolone Pulse Therapy for COVID-19 Pneumonia. COVID. 2022; 2(3):244-253. https://doi.org/10.3390/covid2030019

Chicago/Turabian Style

Yokota, Kazuhiro, Hisashi Noma, Norihito Tarumoto, Noriomi Ishibashi, Jun Sakai, Shigefumi Maesaki, Shinichiro Iida, Yoshitaka Uchida, Takahiro Uchida, Hideto Nakayama, and et al. 2022. "A Retrospective Observational Cohort Study on the Efficacy and Safety of Methylprednisolone Pulse Therapy for COVID-19 Pneumonia" COVID 2, no. 3: 244-253. https://doi.org/10.3390/covid2030019

APA Style

Yokota, K., Noma, H., Tarumoto, N., Ishibashi, N., Sakai, J., Maesaki, S., Iida, S., Uchida, Y., Uchida, T., Nakayama, H., Haga, Y., & Mimura, T. (2022). A Retrospective Observational Cohort Study on the Efficacy and Safety of Methylprednisolone Pulse Therapy for COVID-19 Pneumonia. COVID, 2(3), 244-253. https://doi.org/10.3390/covid2030019

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