Methylprednisolone use in children with severe pneumonia caused by severe acute respiratory syndrome coronavirus 2
Pediatrics International, cilt.65, sa.1, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 65 Sayı: 1
- Basım Tarihi: 2023
- Doi Numarası: 10.1111/ped.15603
- Dergi Adı: Pediatrics International
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, MEDLINE, Veterinary Science Database
- Anahtar Kelimeler: acute respiratory distress syndrome (ARDS), childhood, coronavirus disease 2019 (COVID-19), corticosteroid, interleukin-1 receptor antagonist
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Background: This study aimed to evaluate the effectiveness and optimal use of corticosteroids in children with severe coronavirus disease 2019 (COVID-19) pneumonia, for which effective treatment is still lacking with respect to this population. Methods: We conducted a retrospective study and included patients (aged < 18 years) with severe COVID-19 pneumonia and/or acute respiratory distress syndrome (ARDS) who received standard doses (2–4 mg/kg/day) and high doses (>250 mg/day) of methylprednisolone (MPZ). We adjusted for patients on steroid treatments with a propensity score and compared the side effects of different MPZ doses and patient survival. Results: Fifty-nine patients were included: 61% were male, the median age was 8, interquartile range (IQR) 2–15) years. The overall survival was 84.4% in patients treated with standard-dose MPZ (n = 45, 76.3%) and 92.2% in patients treated with high-dose MPZ (n = 14, 23.7%; p = 0.67). The demographic, clinical, and laboratory data did not differ significantly after propensity score matching, apart from bradycardia, which was a prominent feature of the high-dose group. The clinical and radiological response rates on day 7 were higher and the need for invasive mechanical ventilation (IMV) was lower in the high-dose group. Conclusion: The patients with high-dose MPZ had better clinical and radiological responses than those with standard-dose MPZ, although the mortality rate did not differ between standard and high-dose regimens of MPZ.