Buso Roberta, Cinetto Francesco, Dell'Edera Alessandro, Veneran Nicola, Facchini Cesarina, Biscaro Valeria, Schiavon Stefania, Vian Elisa, Grossi Ugo, Zanus Giacomo, Giobbia Mario, Scarpa Riccardo, Agostini Carlo, Rattazzi Marcello, Felice Carla
Medicine 1 Unit, Department of Medicine, Ca' Foncello University Hospital, 31100 Treviso, Italy.
Department of Medicine, DIMED, University of Padova, 35122 Padova, Italy.
J Clin Med. 2021 Dec 12;10(24):5812. doi: 10.3390/jcm10245812.
(1) Background: Data on different steroid compounds for the treatment of hospitalized COVID-19 (coronavirus disease 2019) patients are still limited. The aim of this study was to compare COVID-19 patients admitted to non-intensive units and treated with methylprednisolone or dexamethasone. (2) Methods: This was a single-center retrospective study that included consecutive patients with COVID-19 hospitalized in medical wards during the second wave of the pandemic. Thirty-day mortality and the need for intensive or semi-intensive care were the main clinical outcomes analyzed in patients receiving methylprednisolone (60 mg/day) compared with dexamethasone (6 mg/day). Secondary outcomes included complication rates, length of hospital stay, and time to viral clearance. (3) Results: Two-hundred-forty-six patients were included in the analysis, 110 treated with dexamethasone and 136 with methylprednisolone. No statistically significant differences were found between the two groups of patients regarding 30-day mortality (OR 1.35, CI95% 0.71-2.56, = 0.351) and the need for intensive or semi-intensive care (OR 1.94, CI95% 0.81-4.66, = 0.136). The complication rates, length of hospital stay, and time to viral clearance did not significantly differ between the two groups. (4) Conclusions: In patients hospitalized for COVID-19 in non-intensive units, the choice of different steroid compounds, such as dexamethasone or methylprednisolone, did not affect the main clinical outcomes.
(1)背景:关于不同类固醇化合物用于治疗住院的2019冠状病毒病(COVID-19)患者的数据仍然有限。本研究的目的是比较入住非重症监护病房并接受甲泼尼龙或地塞米松治疗的COVID-19患者。(2)方法:这是一项单中心回顾性研究,纳入了在疫情第二波期间在医疗病房住院的连续性COVID-19患者。将接受甲泼尼龙(60毫克/天)治疗的患者与接受地塞米松(6毫克/天)治疗的患者进行比较,分析的主要临床结局为30天死亡率以及转入重症或半重症监护的需求。次要结局包括并发症发生率、住院时间和病毒清除时间。(3)结果:246例患者纳入分析,110例接受地塞米松治疗,136例接受甲泼尼龙治疗。两组患者在30天死亡率(比值比1.35,95%置信区间0.71 - 2.56,P = 0.351)和转入重症或半重症监护的需求(比值比1.94,95%置信区间0.81 - 4.66,P = 0.136)方面未发现统计学显著差异。两组之间的并发症发生率、住院时间和病毒清除时间也无显著差异。(4)结论:在非重症监护病房住院的COVID-19患者中,选择不同的类固醇化合物,如地塞米松或甲泼尼龙,不会影响主要临床结局。