USE OF METHYLPREDNISOLONE AS RESCUE IN COVID-19 PATIENTS WITH INAPPROPRIATE USE OF DEXAMETHASONE

Abstract

Objective: To evaluate the use of methylprednisolone at a dose of 80 mg intravenously every 12 hours for 3 days in COVID-19 patients where dexamethasone 6mg intravenously was previously used without indication according to the RECOVERY study (patients without ventilatory support) in mortality at 28 days and recovery of ventilatory function. Material and Methods: A descriptive and retrospective study of patients older than 18 years with COVID-19 diagnosed by the antigenic test was carried out, in
whom dexamethasone 6mg was used intravenously every 24 hours without indication according to the RECOVERY study. In these patients, methylprednisolone 80 mg every 12 hours was used intravenously for 3 days as well as a conventional support therapy for the time. Mortality at 28 days and recovery of ventilatory function were also evaluated. Results: Of the 10 patients, 5 were male and 5 were female with a mean age of 57.8 +- 11 years. All patients received intravenous dexamethasone 6 mg every 24 hours prior to the intervention for an average of 3.9 days. Oxygen saturation decreased in the period of dexamethasone misuse from an average of 92.6% to 83.4%. The average percentage of lung involvement after inadequate treatment with dexamethasone was 49.5% on average. Oxygen use at that time was 12.2 liters per minute per reservoir mask on average. Methylprednisolone 80 mg was used intravenously every 12 hours for 3 days as rescue therapy, after which stabilization in oxygen consumption could be observed.
The mean weaning time from oxygen treatment was 21.5 days. Mortality at 28 days was evaluated in these series, which was 0%.
Conclusions: Although it is true that benefits have been found in the use of methylprednisolone as rescue in COVID-19 patients, it is necessary to carry out properly designed prospective studies to establish with certainty the benefit outlined here, defining clear inclusion criteria, forms of treatment, doses and time of this.