El Mezzeoui Sanae, El Aidouni Ghizlane, Merbouh Manal, El Kaouini Abderrahim, Aftiss Fatima Zahra, Berrichi Samia, Berrajaa Sara, Bkiyer Houssam, Abda Naima, Housni Brahim
Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco.
Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Morocco.
Ann Med Surg (Lond). 2021 Oct;70:102858. doi: 10.1016/j.amsu.2021.102858. Epub 2021 Sep 14.
Corona virus disease 19 (Covid-19) affects especially the respiratory tract, and induces lung injury which may progress to the acute respiratory distress syndrome (ARDS). Various treatment options were tried all over the world, corticosteroids had showed beneficial effects.The Objective of this study, is to compare the safety and efficiency of two corticosteroids: dexamethasone and prednisolone in the treatment of Covid-19 infection.
This retrospective and comparative study included 513 patients diagnosed with Covid-19 infection and were admitted to intensive care unit of our university hospital center of MOHAMMED VI Oujda from March 1, 2020, to December 31st 2020.
In this study, 513 cases were included, 230 patients were received methylprednisolone, and 283 were treated with dexamethasone. The median age in methylprednisolone group was 64 years, and 63 years in the second group treated with dexamethasone. Patients treated with dexamethasone had more critically lesions compared to patients treated with methylprednisolone (67.6%), these patients had a good evolution with a significant reduction of oxygen supplementation, lower use of invasive ventilation and a significant improvement in biological parameters. The difference in outcome between the two groups in terms of mortality was significantly reduced in the second group.
Both steroids are efficient in the management of mild, moderate and severe Covid-19 pneumonia with a clear superiority of dexamethasone especially in severe forms.
新型冠状病毒肺炎(Covid-19)尤其会影响呼吸道,并引发可能进展为急性呼吸窘迫综合征(ARDS)的肺损伤。世界各地尝试了各种治疗方案,皮质类固醇已显示出有益效果。本研究的目的是比较两种皮质类固醇:地塞米松和泼尼松龙在治疗Covid-19感染中的安全性和有效性。
这项回顾性比较研究纳入了513例被诊断为Covid-19感染并于2020年3月1日至2020年12月31日入住我校医院中心穆罕默德六世乌季达重症监护病房的患者。
本研究纳入513例病例,230例患者接受甲泼尼龙治疗,283例接受地塞米松治疗。甲泼尼龙组的中位年龄为64岁,地塞米松治疗的第二组为63岁。与接受甲泼尼龙治疗的患者相比,接受地塞米松治疗的患者有更严重的病变(67.6%),这些患者病情好转,吸氧显著减少,有创通气使用减少,生物学参数有显著改善。两组在死亡率方面的结局差异在第二组中显著降低。
两种类固醇在治疗轻度、中度和重度Covid-19肺炎方面均有效,地塞米松具有明显优势,尤其是在重症形式中。