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SYSTEMATIC REVIEW article

Front. Med.
Sec. Pulmonary Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1428581

The role of methylprednisolone in severe COVID-19 patients: A meta-analysis

Provisionally accepted
WanRu Xu WanRu Xu 1*YuJun Zeng YuJun Zeng 1Hedong Han Hedong Han 2Tangfeng Lv Tangfeng Lv 2*Dang Lin Dang Lin 1*
  • 1 Suzhou Municipal Hospital, Suzhou, China
  • 2 Department of Respiratory and Critical Care Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Background: The purpose of this study is to assess the effectiveness of methylprednisolone in severe COVID-19.Methods: PubMed, the Cochrane Library and Web of Science were searched for literatures comparing methylprednisolone and control treatment in severe COVID-19 patients. Statistical pooling was reported as risk ratio (RR) with corresponding 95 % confidence interval (CI). The outcomes of interest in the literature survey were mortality and adverse events.Results: A total of 13 studies were included, including 3138 patients with severe COVID-19, of which 1634 patients were treated with methylprednisolone and 1504 patients were treated with control treatment. 5 of the 13 studies reported severe adverse events. Our meta-analysis indicates that methylprednisolone treatment in COVID-19 patients is associated with a significant reduction in mortality (RR 0.62, 95% CI 0.46-0.85, P=0.003) compared to control treatment, without an increased risk of adverse events (RR 1.20, 95% CI 0.92-1.56, P=0.17). Moreover, high-dose methylprednisolone treatment (RR 0.57; 95% CI 0.40-0.82, P=0.003) and short-course methylprednisolone treatment (RR 0.54; 95% CI 0.38-0.89, P=0.01) found to significantly reduce mortality. Additionally, it was found that younger severe COVID-19 patients (RR 0.40; 95% CI 0.20-0.80, P=0.01) had better outcomes to methylprednisolone than older patients.Conclusion: Methylprednisolone was correlated with lower mortality compared with control treatment in severe covid-19 patients without increasing serious adverse reactions. Furthermore, high-doses and short-term of methylprednisolone treatment were linked with better younger COVID-19 reported higher benefit from methylprednisolone than older COVID-19 patients.

    Keywords: COVID-19, Severe, Methylprednisolone, Mortality, Adverse event

    Received: 06 May 2024; Accepted: 30 Jul 2024.

    Copyright: © 2024 Xu, Zeng, Han, Lv and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    WanRu Xu, Suzhou Municipal Hospital, Suzhou, China
    Tangfeng Lv, Department of Respiratory and Critical Care Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing, Liaoning Province, China
    Dang Lin, Suzhou Municipal Hospital, Suzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.