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Comparison of the Effect of Intravenous Dexamethasone and Methylprednisolone on the Treatment of Hospitalized Patients With Covid-19: A Randomized Clinical Trial Publisher Pubmed



Dastenae ZH1 ; Bahadori A2 ; Dehghani M3 ; Asadisamani M4 ; Izadi I5 ; Shahraki HR6
Authors
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Authors Affiliations
  1. 1. Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
  2. 2. Department of Anesthesiology, School of Medicine, Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
  3. 3. Shahrekord University of Medical Sciences, Shahrekord, Iran
  4. 4. Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
  5. 5. Khansar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

Source: International Journal of Infectious Diseases Published:2022


Abstract

Objective: In this study, we aimed to compare the effects of intravenous dexamethasone and methylprednisolone on the treatment of inpatients with COVID-19. Methods: In this randomized clinical trial, 143 patients under 80 years of age with moderate to severe COVID-19 were enrolled and randomly assigned to two groups: dexamethasone (8 mg/day) and methylprednisolone (60 mg/day in two divided doses). The primary outcome was the length of hospital stay. The secondary outcomes included: duration of oxygen therapy, absolute leukocyte and lymphocyte count, hypokalemia, hyperglycemia, intensive care unit admission, and mortality in the two groups for 28 days. Data were analyzed by SPSS version 26 using t-test, chi-square, and analysis of variance. Results: The duration of hospitalization was significantly (P <0.001) shorter in the dexamethasone group than in the methylprednisolone group (8 [95% confidence interval [CI]:6-10] and 11 [95% CI: 7-14], respectively). In addition, the duration of oxygen therapy in the dexamethasone group (7 [95% CI: 5-9]) was significantly (P <0.001) shorter than in the methylprednisolone group (10 [95% CI: 5.5-14]). The mortality rate was 17.1% (95% CI: 8.1-26.1) in the dexamethasone group and 12.3% (95% CI: 4.6-20.0) in the methylprednisolone group, which was not statistically significant (P = 0.46). Conclusion: Results showed better effectiveness of 8 mg/day dexamethasone compared with 60 mg/day methylprednisolone based on the shorter hospital stay, which can be considered in the therapeutic protocol of COVID-19. Trial registration:: IRCT20210223050466N1. © 2022
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