2026-04-30T04:58:19Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/577852025-03-07T07:29:40Zcom_10324_1179com_10324_931com_10324_894col_10324_1306

00925njm 22002777a 4500 dc Corral Gudino, Luis author Cusacovich Torres, Iván author Martín González, José Ignacio author Muela Molinero, Alberto author Abadia Otero, Jesica author González Fuentes, Roberto author Ruiz de Temiño de la Peña, Ángela author Tapia Moral, Elena author Cuadrado Medina, Francisca author Martín Asenjo, Miguel author Miramontes González, José Pablo author Delgado González, José Luis author Inés, Sandra author Abad Manteca, Laura author Usátegui Martín, Iciar author Ruiz Albi, Tomás author Miranda Riaño, Sara author Rodríguez Fortúnez, Patricia author Rodríguez Jiménez, Consuelo author López Franco, Esperanza author Marcos, Miguel author 2022 Background: The efficacy and safety of high versus medium doses of glucocorticoids for the treatment of patients with COVID-19 has shown mixed outcomes in controlled trials and observational studies. We aimed to evaluate the effectiveness of methylprednisolone 250 mg bolus versus dexamethasone 6 mg in patients with severe COVID-19. Methods: A randomised, open-label, controlled trial was conducted between February and August 2021 at four hospitals in Spain. The trial was suspended after the first interim analysis since the investigators considered that continuing the trial would be futile. Patients were randomly assigned in a 1:1 ratio to receive dexamethasone 6 mg once daily for up to 10 days or methylprednisolone 250 mg once daily for 3 days. Results: Of the 128 randomised patients, 125 were analysed (mean age 60 ± 17 years; 82 males [66%]). Mortality at 28 days was 4.8% in the 250 mg methylprednisolone group versus 4.8% in the 6 mg dexamethasone group (absolute risk difference, 0.1% [95% CI, −8.8 to 9.1%]; p = 0.98). None of the secondary outcomes (admission to the intensive care unit, non-invasive respiratory or high-flow oxygen support, additional immunosuppressive drugs, or length of stay), or prespecified sensitivity analyses were statistically significant. Hyperglycaemia was more frequent in the methylprednisolone group at 27.0 versus 8.1% (absolute risk difference, −18.9% [95% CI, −31.8 to - 5.6%]; p = 0.007). Conclusions: Among severe but not critical patients with COVID-19, 250 mg/d for 3 days of methylprednisolone compared with 6 mg/d for 10 days of dexamethasone did not result in a decrease in mortality or intubation. European Journal of Clinical Investigation, 2022, vol. 53, n. 1, e13881. 0014-2972 https://uvadoc.uva.es/handle/10324/57785 10.1111/eci.13881 1 European Journal of Clinical Investigation 53 1365-2362 Effect of intravenous pulses of methylprednisolone 250 mg versus dexamethasone 6 mg in hospitalised adults with severe COVID ‐19 pneumonia: An open‐label randomised trial