Hospitalization for COVID-19 shorter with dexamethasone vs methylprednisolone

In the treatment of COVID-19 inpatients, intravenous administration of dexamethasone leads to a shorter hospital stay compared with methylprednisolone, according to a study.

The study included 143 patients with moderate to severe COVID-19. They were randomized to receive either dexamethasone (8 mg/day; mean age 64.51 years) or methylprednisolone (60 mg/day in two divided doses; mean age 64.51 years).

The treatment groups were similar in terms of gender and comorbidities including diabetes mellitus (27.4 percent vs 24.3 percent), hypertension (50.7 percent vs 44.3 percent), ischaemic heart disease (11.0 percent vs 12.9 percent), lung disease (15.1 percent vs 10.0 percent), and autoimmune disease (5.5 percent vs 1.4 percent).

The primary outcome of the length of hospital stay was significantly shortened with dexamethasone than with methylprednisolone (8 days, 95 percent confidence interval [CI], 6–10 vs 11 days, 95 percent CI, 7–14; p<0.001).

Furthermore, oxygen therapy duration was 3 days shorter with dexamethasone (7 days, 95 percent confidence interval [CI], 5–9 vs 10 days, 95 percent CI, 5.5–14; p<0.001). On the other hand, there was no significant between-group differences seen in mortality rate (17.1 percent, 95 percent CI, 8.1–26.1 vs 12.3 percent, 95 percent CI, 4.6–20.0; p=0.46).

Hypokalaemia and hyperglycaemia occurred with significantly less frequency in the dexamethasone vs methylprednisolone group (11.4 percent and 36.8 percent vs 24.7 percent and 78.1 percent; p<0.05).

The findings indicate that dexamethasone can be considered in the therapeutic protocol for COVID-19.