The Effect of Dexamethasone versus Methylprednisolone in the Treatment of COVID-19 Patients in Jordan  

作　　者：Jamal Wadi Al Ramahi Nour Hasan Amal Matar Ma’en Maher Al-Ali Lara Abdulhadi Dania Abu Kaf Waseem Saadeh Nour Hamdan Hassan Abu Khalaf Mohamed Gharaibeh Hanadi Hamadallah Ala’a Bader Mohammad Atout Sae’ed Moh. Mar’I Tamer Alhamed Jamal Wadi Al Ramahi;Nour Hasan;Amal Matar;Ma’en Maher Al-Ali;Lara Abdulhadi;Dania Abu Kaf;Waseem Saadeh;Nour Hamdan;Hassan Abu Khalaf;Mohamed Gharaibeh;Hanadi Hamadallah;Ala’a Bader;Mohammad Atout;Sae’ed Moh. Mar’I;Tamer Alhamed(Department of Medicine, School of Medicine, The University of Jordan, Amman, Jordan;Clinical Pharmacy, Al Khalidi Hospital, Amman, Jordan;Department of General Medicine, Al Khalidi Hospital, Amman, Jordan;Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan;Department of Medicine, The Specialty Hospital, Amman, Jordan;Department of Anesthesia, The Specialty Hospital, Amman, Jordan;Department of Pharmacy, Jordan Hospital, Amman, Jordan;Department of Pharmacy, The Specialty Hospital, Amman, Jordan)

机构地区：[1]Department of Medicine, School of Medicine, The University of Jordan, Amman, Jordan [2]Clinical Pharmacy, Al Khalidi Hospital, Amman, Jordan [3]Department of General Medicine, Al Khalidi Hospital, Amman, Jordan [4]Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan [5]Department of Medicine, The Specialty Hospital, Amman, Jordan [6]Department of Anesthesia, The Specialty Hospital, Amman, Jordan [7]Department of Pharmacy, Jordan Hospital, Amman, Jordan [8]Department of Pharmacy, The Specialty Hospital, Amman, Jordan

出　　处：《Advances in Infectious Diseases》2023年第3期508-520,共13页传染病进展（英文）

摘　　要：Background: Previous studies focused on the treatment effect of steroids versus no steroids in treating severe COVID-19 patients, a few studies evaluated outcomes for treating those patients with either dexamethasone or methylprednisolone. Currently, we evaluate the difference in mortality associated with treating COVID-19 patients with dexamethasone versus methylprednisolone. Methods: With a retrospective multicenter study, records were reviewed for the admitted patients with severe COVID-19 during the peak of the severe COVID-19 pandemic. All admitted patients on dexamethasone or methylprednisolone were included. Patients were analyzed as all populations and propensity scores matched patients. Propensity scores were calculated for several confounders by the generalized linear model, and a “greedy” near-neighbor matching algorithm was used. Continuous variables with nonnormal distribution were analyzed by Wilcoxon signed rank test. Chi-squared and Fischer exact test analyzed categorical variables. P-values were adjusted by the Bonferroni method for both data cohorts. Body mass index was in categories. Radiological findings were divided into five categories. The outcomes: mortality, the need for home oxygen therapy, recovery, and residual symptoms on discharge were analyzed by an independent two-sample test for equality of proportions (with Yates correction), and logistic regression analysis. Results: Among the 1128 reviewed records, patients on dexamethasone or methylprednisolone were 1071, and the propensity score-matched patients were 784: dexamethasone 393 and methylprednisolone 391. There was no significant difference in the characteristics of patients between the two steroids (p-value and adjusted p-value > 0.05) for most variables. PSM adjusted a few discrepant variables before analysis. The outcome of the unmatched patients demonstrated dexamethasone benefit in the need for home oxygen therapy ( 0.05). However, matched patients demonstrated significantly lower mortality associated with dexamethasone tBackground: Previous studies focused on the treatment effect of steroids versus no steroids in treating severe COVID-19 patients, a few studies evaluated outcomes for treating those patients with either dexamethasone or methylprednisolone. Currently, we evaluate the difference in mortality associated with treating COVID-19 patients with dexamethasone versus methylprednisolone. Methods: With a retrospective multicenter study, records were reviewed for the admitted patients with severe COVID-19 during the peak of the severe COVID-19 pandemic. All admitted patients on dexamethasone or methylprednisolone were included. Patients were analyzed as all populations and propensity scores matched patients. Propensity scores were calculated for several confounders by the generalized linear model, and a “greedy” near-neighbor matching algorithm was used. Continuous variables with nonnormal distribution were analyzed by Wilcoxon signed rank test. Chi-squared and Fischer exact test analyzed categorical variables. P-values were adjusted by the Bonferroni method for both data cohorts. Body mass index was in categories. Radiological findings were divided into five categories. The outcomes: mortality, the need for home oxygen therapy, recovery, and residual symptoms on discharge were analyzed by an independent two-sample test for equality of proportions (with Yates correction), and logistic regression analysis. Results: Among the 1128 reviewed records, patients on dexamethasone or methylprednisolone were 1071, and the propensity score-matched patients were 784: dexamethasone 393 and methylprednisolone 391. There was no significant difference in the characteristics of patients between the two steroids (p-value and adjusted p-value > 0.05) for most variables. PSM adjusted a few discrepant variables before analysis. The outcome of the unmatched patients demonstrated dexamethasone benefit in the need for home oxygen therapy ( 0.05). However, matched patients demonstrated significantly lower mortality associated with dexamethasone t

关 键 词：DEXAMETHASONE METHYLPREDNISOLONE COVID-19 Mortality Home Oxygen COVID-19 Recovery 

分 类 号：R73[医药卫生—肿瘤]