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Evaluation of the use of methylprednisolone and dexamethasone in asthma critically ill patients with COVID-19: a multicenter cohort study.
Al Sulaiman, Khalid; Aljuhani, Ohoud; Korayem, Ghazwa B; Altebainawi, Ali; Alharbi, Reham; Assadoon, Maha; Vishwakarma, Ramesh; Ismail, Nadia H; Alshehri, Asma A; Al Mutairi, Faisal E; AlFaifi, Mashael; Alharthi, Abdullah F; Alenazi, Abeer A; Alalawi, Mai; Al Zumai, Omar; Al Haji, Hussain; Al Dughaish, Sarah T; Alawaji, Abdulrahman S; Alhaidal, Haifa A; Al Ghamdi, Ghassan.
Afiliación
  • Al Sulaiman K; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.
  • Aljuhani O; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.
  • Korayem GB; King Abdullah International Medical Research Center (KAIMRC), KSAU-HS, PO Box 22490, Riyadh, 11426, Saudi Arabia. alsulaimankh@hotmail.com.
  • Altebainawi A; Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia. alsulaimankh@hotmail.com.
  • Alharbi R; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
  • Assadoon M; Department of Pharmacy Practice, Princess Nourah bint Abdulrahman University, Riyadh, P.O.Box 84428, 11671, Saudi Arabia.
  • Vishwakarma R; Pharmaceutical Care Services, King Khalid Hospital, Hail, Saudi Arabia.
  • Ismail NH; College of Pharmacy, University of Hail, Hail, Saudi Arabia.
  • Alshehri AA; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.
  • Al Mutairi FE; Norwich Medical School, University of East Anglia, Norwich, UK.
  • AlFaifi M; King Fahad Hospital of the University, AL-Khobar, Saudi Arabia.
  • Alharthi AF; Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
  • Alenazi AA; Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
  • Alalawi M; Pharmaceutical Care Department, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.
  • Al Zumai O; Pharmaceutical Services Administration, King Saud Medical City, Riyadh, Saudi Arabia.
  • Al Haji H; College of Pharmacy, Shaqra University, Shaqra, Saudi Arabia.
  • Al Dughaish ST; Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
  • Alawaji AS; Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
  • Alhaidal HA; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.
  • Al Ghamdi G; Respiratory Department Services, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.
BMC Pulm Med ; 23(1): 315, 2023 Aug 28.
Article en En | MEDLINE | ID: mdl-37641042
BACKGROUND: Previous studies have shown mortality benefits with corticosteroids in Coronavirus disease-19 (COVID-19). However, there is inconsistency regarding the use of methylprednisolone over dexamethasone in COVID-19, and this has not been extensively evaluated in patients with a history of asthma. This study aims to investigate and compare the effectiveness and safety of methylprednisolone and dexamethasone in critically ill patients with asthma and COVID-19. METHODS: The primary endpoint was the in-hospital mortality. Other endpoints include 30-day mortality, respiratory failure requiring mechanical ventilation (MV), acute kidney injury (AKI), acute liver injury, length of stay (LOS), ventilator-free days (VFDs), and hospital-acquired infections. Propensity score (PS) matching, and regression analyses were used. RESULTS: A total of one hundred-five patients were included. Thirty patients received methylprednisolone, whereas seventy-five patients received dexamethasone. After PS matching (1:1 ratio), patients who received methylprednisolone had higher but insignificant in-hospital mortality in both crude and logistic regression analysis, [(35.0% vs. 18.2%, P = 0.22) and (OR 2.31; CI: 0.56 - 9.59; P = 0.25), respectively]. There were no statistically significant differences in the 30-day mortality, respiratory failure requiring MV, AKI, acute liver injury, ICU LOS, hospital LOS, and hospital-acquired infections. CONCLUSIONS: Methylprednisolone in COVID-19 patients with asthma may lead to increased in-hospital mortality and shorter VFDs compared to dexamethasone; however, it failed to reach statistical significance. Therefore, it is necessary to interpret these data cautiously, and further large-scale randomized clinical trials are needed to establish more conclusive evidence and support these conclusions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Infección Hospitalaria / Lesión Renal Aguda / COVID-19 Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: BMC Pulm Med Año: 2023 Tipo del documento: Article País de afiliación: Arabia Saudita

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Infección Hospitalaria / Lesión Renal Aguda / COVID-19 Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: BMC Pulm Med Año: 2023 Tipo del documento: Article País de afiliación: Arabia Saudita
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