Abstract
Glucocorticoid therapy for a cytokine storm is one of the mainstays of managing the novel coronavirus disease COVID-19. The aim of this study was to evaluate the efficacy of methylprednisolone at different stages of medical care: in an intensive care unit (ICU) vs. a medical ward setting. Methylprednisolone therapy was delivered to 54 patients, amounting to 9% of the total patients hospitalized to the Federal Center of Brain Research and Neurotechnology of FMBA, Russia. Twenty-eight patients received methylprednisolone in the ICU setting; 26 patients, in a medical ward setting. The control group comprised 14 patients. Methylprednisolone was administered continuously, intravenously at 250 mg per day over the course of 3 days; the total dose was 750 mg. The analysis revealed a significant reduction in mortality in the group receiving methylprednisolone in a medical ward setting (7.7%) in comparison with the group receiving the drug in ICU (67.9%) and the control group (42.9%, р<0.001). The need for mechanical ventilation was lower in the group receiving methylprednisolone in a medical ward (2 (7.7%), 20 (71.4%) and 7 (50%) cases, respectively, р<0.001). Thus, preventive anti-inflammatory methylprednisolone therapy for delivered in a medical ward setting reduces hospital mortality and the need for MV in patients with COVID-19-induced pneumonia.
Highlights
Glucocorticoid therapy for a cytokine storm is one of the mainstays of managing the novel coronavirus disease COVID-19
The analysis of comorbidities revealed that group 1 was dominated by patients with chronic heart failure (CHF) and chronic kidney disease (CKD); these conditions were observed in 39.3% (р = 0.009) and 25% (р = 0.017) of patients, respectively
This study investigated effects of methylprednisolone therapy at different stages of inpatient medical care
Summary
Glucocorticoid therapy for a cytokine storm is one of the mainstays of managing the novel coronavirus disease COVID-19. Twenty-eight patients received methylprednisolone in the ICU setting; 26 patients, in a medical ward setting. Preventive anti-inflammatory methylprednisolone therapy for delivered in a medical ward setting reduces hospital mortality and the need for MV in patients with COVID-19-induced pneumonia. ИССЛЕДОВАНИЕ ЭФФЕКТИВНОСТИ МЕТИЛПРЕДНИЗОЛОНА НА РАЗНЫХ ЭТАПАХ ОКАЗАНИЯ СТАЦИОНАРНОЙ МЕДИЦИНСКОЙ ПОМОЩИ ПАЦИЕНТАМ С ПНЕВМОНИЕЙ, ВЫЗВАННОЙ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИЕЙ COVID-19. Целью настоящего исследования явилось изучение эффективности применения метилпреднизолона на разных этапах оказания стационарной медицинской помощи — в условиях отделения реанимации и интенсивной терапии (ОРИТ) и в терапевтических отделениях (ТО). Введение метилпреднизолона в условиях терапевтического отделения в качестве упреждающей противовоспалительной терапии способствует снижению показателей больничной летальности и частоты использования ИВЛ у пациентов с пневмонией, вызванной новой коронавирусной инфекцией COVID-19. The devastating consequences of uncontrolled cytokine release include damage to the lungs, diffuse alveolar damage, acute respiratory distress syndrome (ARDS), and death [2–5]
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