Aomar-Millán Ismael F, Fatoul-Del Pino Geoorgette, Torres-Parejo Úrsula, Pérez Fernández Laura, Martínez-Diz Silvia, Salvatierra Juan
Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, Spain.
Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain.
Med Clin (Engl Ed). 2023 Feb 24;160(4):156-159. doi: 10.1016/j.medcle.2023.01.002. Epub 2023 Jan 24.
To compare the 30-day outcome (mortality and/or ICU admission) of patients admitted for moderate-severe SARS-CoV-2 pneumonia treated with dexamethasone after the Recovery study versus those treated with weight-adjusted methylprednisolone.
Retrospective cohort study of 65 patients with moderate-severe pneumonia who received dexamethasone 6 mg/day (DXM group) versus 80 treated with weight-adjusted methylprednisolone (MTPN group).
21 (32.3%) patients in the DXM group died vs 8 (10%) in the MTPN group (p-value < 0.001) and 29 (44.6%) in the DXM group required ICU admission vs 2 (2,5%) of the MTPN group (p-value <0.001). There were no baseline differences regarding sociodemographic characteristics with a higher mean qSOFA in the MTPN group. The hazard ratio for mortality and ICU admission adjusted for age, sex, and admission CRP was 2.189 (1.082-4.426; 95% CI) and 10.589 (2.139-48.347; 95% CI) for the DXM group, respectively, vs. MTPN group.
Mortality and admission to the ICU were lower in patients treated with weight-adjusted methylprednisolone compared to those treated with dexamethasone.
比较在康复研究后接受地塞米松治疗的中度至重度SARS-CoV-2肺炎患者与接受体重调整的甲泼尼龙治疗的患者的30天结局（死亡率和/或入住重症监护病房）。
对65例接受6毫克/天的地塞米松治疗的中度至重度肺炎患者（地塞米松组）和80例接受体重调整的甲泼尼龙治疗的患者（甲泼尼龙组）进行回顾性队列研究。
地塞米松组21例（32.3%）患者死亡，而甲泼尼龙组为8例（10%）（p值<0.001）；地塞米松组29例（44.6%）患者需要入住重症监护病房，而甲泼尼龙组为2例（2.5%）（p值<0.001）。两组在社会人口统计学特征方面无基线差异，但甲泼尼龙组的平均序贯器官衰竭评估（qSOFA）较高。在对年龄、性别和入院时的C反应蛋白进行调整后，地塞米松组与甲泼尼龙组相比，死亡和入住重症监护病房的风险比分别为2.189（1.082 - 4.426；95%置信区间）和10.589（2.139 - 48.347；95%置信区间）。
与接受地塞米松治疗的患者相比，接受体重调整的甲泼尼龙治疗的患者死亡率和入住重症监护病房的比例更低。
