Moghaddam Alireza Ziaei, Soleimani Mostafa, Imani Behnam, Hejazi Sepideh, Taherynejad Mohammadhossein, Kabiri Mona, Emadzadeh Maryam, Ravanshad Sahar
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Recent Adv Inflamm Allergy Drug Discov. 2025;19(2):259-268. doi: 10.2174/0127722708310247240718100251.
The Coronavirus disease 2019 (COVID-19) pandemic, prompted by SARS-CoV-2, has created complicated health crises. An excessive inflammatory response and cytokine storm characterize severe COVID-19. Corticosteroids like dexamethasone and methylprednisolone are used for their anti-inflammatory effects, but comparisons of their efficacy are lacking.
This study seeks to rigorously assess and contrast the effectiveness of dexamethasone and methylprednisolone in combating COVID-19 infections.
This retrospective clinical study evaluates the effects of these two corticosteroids by reviewing the files of 500 hospitalized COVID-19 patients. The baseline characteristics of the patients, chest CT severity score, type of steroid prescription, duration of hospitalization and steroid prescription, dosage of corticosteroid therapy, their recovery status, hospital mortality, and specific disease severity-associated markers, such as lactate dehydrogenase (LDH), complete blood count (CBC), C-reactive protein (CRP), and Erythrocyte sedimentation rate (ESR) were collected and compared.
The study found no significant difference in most disease severity-associated markers between the two corticosteroid groups. However, lower mortality rates and shortened hospital stays were significantly associated with dexamethasone, especially in critical patient groups. A detailed analysis of inflammatory markers suggested minimal differences based on the type of corticosteroid used.
The study indicates that dexamethasone may have some advantages in specific clinical outcomes. Further research needs to explore the mechanisms involved despite similar anti-inflammatory profiles.
由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引发的2019冠状病毒病(COVID-19)大流行造成了复杂的健康危机。严重COVID-19的特征是过度炎症反应和细胞因子风暴。地塞米松和甲泼尼龙等皮质类固醇因其抗炎作用而被使用,但它们疗效的比较尚缺乏。
本研究旨在严格评估和对比地塞米松与甲泼尼龙对抗COVID-19感染的有效性。
这项回顾性临床研究通过查阅500例住院COVID-19患者的病历,评估这两种皮质类固醇的效果。收集并比较患者的基线特征、胸部CT严重程度评分、类固醇处方类型、住院时间和类固醇处方、皮质类固醇治疗剂量、恢复状况、医院死亡率以及特定疾病严重程度相关指标,如乳酸脱氢酶(LDH)、全血细胞计数(CBC)、C反应蛋白(CRP)和红细胞沉降率(ESR)。
该研究发现,两个皮质类固醇组在大多数疾病严重程度相关指标上没有显著差异。然而,较低的死亡率和缩短的住院时间与地塞米松显著相关,尤其是在重症患者组中。对炎症标志物的详细分析表明,根据所用皮质类固醇的类型,差异极小。
该研究表明,地塞米松在特定临床结果方面可能具有一些优势。尽管抗炎特性相似,但仍需进一步研究探索其中涉及的机制。