Evaluation of personalized methylprednisolone therapy in critically ill COVID-19 patients: an observational comparative study using real-life data

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dc.contributor.authorDuman, I
dc.contributor.authorCelik, J. B.
dc.contributor.authorIyisoy, M. S.
dc.contributor.authorDegirmencioglu, S.
dc.contributor.authorKorkmaz, A.
dc.contributor.authorDuman, A.
dc.date.accessioned2024-02-23T14:49:30Z
dc.date.available2024-02-23T14:49:30Z
dc.date.issued2022
dc.departmentNEÜen_US
dc.description.abstractOBJECTIVE: Methylprednisolone is commonly used to attenuate the cytokine storm and prevent mortality in COVID-19 pneumonia. However, the optimal methylprednisolone dose and duration are unclear. Additional data are required on the effectiveness of methylprednisolone in reducing mortality in COVID-19. This real-life retrospective study aimed to analyze the data of a COVID-19 dedicated ICU and compare the mortality rates of standard care, low-dose, and pulse-dose met hylprednisolone in patients requiring mechanical ventilatory support. PATIENTS AND METHODS: Methylprednisolone's indication. dose. and duration were determined according to the severity of COVID-19 pneumonia based on the patient's demographic parameters, comorbidities. laboratory data. radiology, and arterial blood gas analysis results. 867 patients were grouped as: no methylprednisolone (standard care), low-dose (0.5-1 mg/kg/day) methylprednisolone or pulse-dose (250-1,000 mg/day) met hylprednisolone. RESULTS: The overall mortality rate was 63.78%. Adjusting the dose of methylprednisolone according to the severity of the disease resulted in statistically similar mortality rates despite the increase in disease severity. Mortality was 62.71% in standard treatment. 65.76% in low-dose, and 62.10% in pulse-dose methylprednisolone groups (p = 0.633). Invasive mechanical ventilation at admission was associated with increased mortality (HR: 1.826 [95% CI: 1.542-2.161]; p < 0.001). Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were also associated with mortality. CONCLUSIONS: Personalizing the dose and duration of methylprednisolone according to the patient's disease severity assessed with demographic, clinical, and laboratory results may benefit mortality in severe COVID-19 patients receiving ventilatory support in the ICU. Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were associated with mortality in our patient cohort.en_US
dc.identifier.endpage4508en_US
dc.identifier.issn1128-3602
dc.identifier.issue12en_US
dc.identifier.pmid35776051en_US
dc.identifier.scopus2-s2.0-85133544503en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage4497en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12452/18234
dc.identifier.volume26en_US
dc.identifier.wosWOS:000823313800010en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherVerduci Publisheren_US
dc.relation.ispartofEuropean Review For Medical And Pharmacological Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCovid-19en_US
dc.subjectMechanical Ventilationen_US
dc.subjectMethylprednisoloneen_US
dc.subjectMortalityen_US
dc.subjectPersonalized Therapyen_US
dc.titleEvaluation of personalized methylprednisolone therapy in critically ill COVID-19 patients: an observational comparative study using real-life dataen_US
dc.typeArticleen_US

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