学术急诊医学档案

卷 14 编号 1 (2026)

Comparative 28-day Outcomes of Pulse-Dose Methylprednisolone versus Prolonged Low-Dose Dexamethasone in Hospitalized COVID-19 Pneumonia: A Cohort Study

学术急诊医学档案, 卷 14 编号 1 (2026), 1 七月 2025 , 第 e53 页
https://doi.org/10.22037/aaem.v14i1.3063

摘要

Introduction: Corticosteroids are widely used in COVID-19 pneumonia; however, the optimal regimen remains uncertain. We compared clinical outcomes between pulse-dose methylprednisolone and prolonged low-dose dexamethasone in hospitalized patients with COVID-19 pneumonia. Methods: In this retrospective cohort study, adult patients hospitalized with COVID-19 pneumonia (18 April–30 August 2021), who received either pulse-dose methylprednisolone or prolonged low-dose dexamethasone, were compared regarding 28-day mortality, in-hospital mortality, and treatment-free days. Multivariable Cox regression and propensity score matching (PSM) were used to adjust for confounding. Results: Among 460 patients (269 pulse-dose methylprednisolone, 191 prolonged low-dose dexamethasone), no significant difference in 28-day mortality was observed in multivariable analysis (aHR: 1.51; 95% CI: 0.74–3.09, p = 0.26). After PSM, 28-day mortality remained similar (HR: 1.40; 95% CI: 0.64–3.06; p = 0.38), although a trend toward higher in-hospital mortality was noted with pulse-dose methylprednisolone (HR: 2.07; 95% CI: 0.96–4.42; p = 0.06). Conclusion: Pulse-dose methylprednisolone was not associated with a significant difference in 28-day mortality compared with prolonged low-dose dexamethasone. A trend toward higher in-hospital mortality was observed with pulse-dose methylprednisolone, warranting cautious interpretation due to potential residual confounding.

关键词:
  • Methylprednisolone
  • Dexamethasone
  • COVID-19
  • SARS-Cov-2
  • Pneumonia
  • Viral

参考

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