Retrospective Evaluation of the Outcome of Covid-19 Patients Given Pulse Methylprednisolone versus Standard Steroid Therapy

Abdelfattah, Ahmed N.; Hamed, Gamal; Ibrahim, Khalid F.; Eldmarawy, Mervat M.; Abbas, Ahmed K.

doi:10.21608/ejmm.2025.368957.1526

Retrospective Evaluation of the Outcome of Covid-19 Patients Given Pulse Methylprednisolone versus Standard Steroid Therapy

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Intensive Care, Theodor Bilharz Research Institute, Giza

² Critical Care Medicine Department, Faculty of Medicine, Cairo University

10.21608/ejmm.2025.368957.1526

Abstract

Background: Except for corticosteroids, no gold standard therapy globally was approved for COVID-19 pneumonia to the date of this study. Studying the pathophysiology of the disease showed that the deterioration that accompany many of cases of COVID-19 pneumonia is related to hyper-immune response causing what is called Cytokine release syndrome/cytokine storm, so, testing various regimens of steroid therapy to control the disease seemed reasonable idea. Objective: To evaluate the results of using different regimens of steroid therapy as a treatment for moderate to severe cases of COVID-19. Methodology: This Study is a retrospective, observational study done on patients with moderate to severe COVID-19 pneumonia who were admitted to the isolation Hospital of Kasr Alainy Medical School, Cairo University, Egypt, between October 2020 and May 2021. Results: In this study we demonstrated statistical difference and increase incidence (ICU stay, need for & length of MV, The incidence of 2ry bacterial infection & GIT bleeding, in hospital mortality) for COVID-19 moderate to severe pneumonia in group A (received pulse steroid therapy) of patients coming during cytokine release syndrome associated COVID-19 pneumonia. Conclusion: Using pulse methyleprednisolone therapy in combination with standard treatment didn’t show additional benefit than that could be achieved using standard regimen alone, it lead to multiple side effects regarding increasing hospital mortality, need for mechanical ventilation (either invasive or non- invasive), duration of ICU stay & increase incidence of 2ry bacterial infection and GIT bleeding in patients with moderate to severe COVID-19 pneumonia. Pulsed dose steroid use was more frequent in patients receiving high respiratory support, so future studies should address patient selection and outcome effects of pulsed steroids in severe and deteriorating patients with COVID-19 pneumonia.

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