Study of the effectiveness of methylprednisolone at different stages of inpatient care for patients with pneumonia caused by a new COVID-19 coronavirus infection
Glucocorticoid therapy for a cytokine storm is one of the mainstays of managing the novel coronavirus disease COVID-19. The aim of this study was to evaluate the efficacy of methylprednisolone at different stages of medical care: in an intensive care unit (ICU) vs. a medical ward setting. Methylprednisolone therapy was delivered to 54 patients, amounting to 9% of the total patients hospitalized to the Federal Center of Brain Research and Neurotechnology of FMBA, Russia. Twenty-eight patients received methylprednisolone in the ICU setting; 26 patients, in a medical ward setting. The control group comprised 14 patients. Methylprednisolone was administered continuously, intravenously at 250 mg per day over the course of 3 days; the total dose was 750 mg. The analysis revealed a significant reduction in mortality in the group receiving methylprednisolone in a medical ward setting (7.7%) in comparison with the group receiving the drug in ICU (67.9%) and the control group (42.9%, р<0.001). The need for mechanical ventilation was lower in the group receiving methylprednisolone in a medical ward (2 (7.7%), 20 (71.4%) and 7 (50%) cases, respectively, р<0.001). Thus, preventive anti-inflammatory methylprednisolone therapy for delivered in a medical ward setting reduces hospital mortality and the need for MV in patients with COVID-19-induced pneumonia.