Which Dose of Pulse Steroid Therapy is More Effective in Oxygen-Requiring Patients Aged 25–65 Hospitalized with SARS-Cov-2 Diagnosis?
Abstract
Objective: SARS-CoV and MERS-CoV are coronaviruses affecting the lower respiratory tract, often leading to severe respiratory failure. Following the emergence of a novel coronavirus, COVID-19 was declared a pandemic. While various treatments have been implemented, the optimal dose for high-dose (pulse) steroid therapy remains undefined. This study aims to evaluate the clinical efficacy of different pulse steroid doses in COVID-19 patients requiring oxygen support.
Methods: This study involved 61 hospitalized patients (aged 25–65) with respiratory distress. Patients were divided into two groups: Group 1 received 250 mg of methylprednisolone (n=31), and Group 2 received 500 mg (n=30). Data on comorbidities, CT features, laboratory parameters, oxygen saturation levels, and clinical outcomes (discharge or mortality) were analyzed.
Results: Comparative analysis showed no statistically significant difference in clinical outcomes or discharge status between the 250 mg and 500 mg treatment groups (p > 0.05). Mortality was most strongly associated with the presence of comorbidities (OR=7.58, p=0.033), elevated baseline CRP levels (OR=6.76, p=0.009), and the duration between PCR positivity and the initiation of steroid therapy (OR=5.72, p=0.012).
Conclusion: Our findings suggest that 250 mg and 500 mg doses of pulse steroid therapy provide similar clinical outcomes in COVID-19 management. The timing of treatment initiation and the patient’s baseline inflammatory state are more critical determinants of survival than the steroid dose itself.
Keywords
COVID-19, SARS-CoV-2, Pulse steroid therapy, Methylprednisolone, Mortality, Oxygen saturation
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