Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study
ABSTRACTIntroduction Trials have demonstrated the benefits of methylprednisolone in the treatment of coronavirus disease 2019 (COVID-19). However, data on optimal dose, duration and timing of administration are limited. This study investigates the outcome of various methylprednisolone treatment regi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20523211.2024.2337125 |
| _version_ | 1797202674174656512 |
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| author | Nur Fatin Najwa Azemi Farida Islahudin Rahela Ambaras Khan Shamin Mohd Saffian Leong Chee Loon |
| author_facet | Nur Fatin Najwa Azemi Farida Islahudin Rahela Ambaras Khan Shamin Mohd Saffian Leong Chee Loon |
| author_sort | Nur Fatin Najwa Azemi |
| collection | DOAJ |
| description | ABSTRACTIntroduction Trials have demonstrated the benefits of methylprednisolone in the treatment of coronavirus disease 2019 (COVID-19). However, data on optimal dose, duration and timing of administration are limited. This study investigates the outcome of various methylprednisolone treatment regimens among hospitalised COVID-19 patients.Methods A retrospective cohort study was conducted on hospitalised adult COVID-19 patients admitted between June and August 2021 in general COVID-19 wards, treated with methylprednisolone. Clinical outcomes evaluated include in-hospital mortality, thirty-day mortality, clinical efficacy (C-reactive protein (CRP), total white blood cells (TWBC) and oxygen requirement) as well as the safety of methylprednisolone.Results Of 278 patients, 1(0.4%) received weight-based dosing of 1 mg/kg/day, 101(36.3%) received weight-based dosing of 2 mg/kg/day, 130(46.8%) received fixed dosing methylprednisolone 250 mg/day and 46(16.5%) received fixed dosing methylprednisolone 500 mg/day. There was a significant difference in in-hospital mortality rates following different methylprednisolone doses whereby in-hospital mortality occurred in 22.5% (n = 23) of patients with 1 or 2 mg/kg/day methylprednisolone, 32.3% (n = 42) with 250 mg/day and 39.1% (n = 18) with 500 mg/day (p = 0.023). On the other hand, no significant difference in thirty-day mortality, clinical efficacy and safety was observed between different dosing regimens (p > 0.05).Conclusion The use of methylprednisolone weight-based dosing in hospitalised COVID-19 patients should be considered due to the positive outcome associated with lower in-hospital mortality. |
| first_indexed | 2024-04-24T08:07:11Z |
| format | Article |
| id | doaj.art-7d412df626a647b795cacf02a576d2eb |
| institution | Directory Open Access Journal |
| issn | 2052-3211 |
| language | English |
| last_indexed | 2024-04-24T08:07:11Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj.art-7d412df626a647b795cacf02a576d2eb2024-04-17T09:47:11ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112024-12-0117110.1080/20523211.2024.2337125Methylprednisolone use in hospitalised COVID-19 patients: a retrospective studyNur Fatin Najwa Azemi0Farida Islahudin1Rahela Ambaras Khan2Shamin Mohd Saffian3Leong Chee Loon4Centre for Quality Management of Medicines, Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, MalaysiaCentre for Quality Management of Medicines, Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, MalaysiaDepartment of Pharmacy, Hospital Kuala Lumpur, Kuala Lumpur, MalaysiaCentre for Quality Management of Medicines, Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, MalaysiaDepartment of Pharmacy, Hospital Kuala Lumpur, Kuala Lumpur, MalaysiaABSTRACTIntroduction Trials have demonstrated the benefits of methylprednisolone in the treatment of coronavirus disease 2019 (COVID-19). However, data on optimal dose, duration and timing of administration are limited. This study investigates the outcome of various methylprednisolone treatment regimens among hospitalised COVID-19 patients.Methods A retrospective cohort study was conducted on hospitalised adult COVID-19 patients admitted between June and August 2021 in general COVID-19 wards, treated with methylprednisolone. Clinical outcomes evaluated include in-hospital mortality, thirty-day mortality, clinical efficacy (C-reactive protein (CRP), total white blood cells (TWBC) and oxygen requirement) as well as the safety of methylprednisolone.Results Of 278 patients, 1(0.4%) received weight-based dosing of 1 mg/kg/day, 101(36.3%) received weight-based dosing of 2 mg/kg/day, 130(46.8%) received fixed dosing methylprednisolone 250 mg/day and 46(16.5%) received fixed dosing methylprednisolone 500 mg/day. There was a significant difference in in-hospital mortality rates following different methylprednisolone doses whereby in-hospital mortality occurred in 22.5% (n = 23) of patients with 1 or 2 mg/kg/day methylprednisolone, 32.3% (n = 42) with 250 mg/day and 39.1% (n = 18) with 500 mg/day (p = 0.023). On the other hand, no significant difference in thirty-day mortality, clinical efficacy and safety was observed between different dosing regimens (p > 0.05).Conclusion The use of methylprednisolone weight-based dosing in hospitalised COVID-19 patients should be considered due to the positive outcome associated with lower in-hospital mortality.https://www.tandfonline.com/doi/10.1080/20523211.2024.2337125MethylprednisoloneCOVID-19mortalityoutcome |
| spellingShingle | Nur Fatin Najwa Azemi Farida Islahudin Rahela Ambaras Khan Shamin Mohd Saffian Leong Chee Loon Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study Journal of Pharmaceutical Policy and Practice Methylprednisolone COVID-19 mortality outcome |
| title | Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study |
| title_full | Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study |
| title_fullStr | Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study |
| title_full_unstemmed | Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study |
| title_short | Methylprednisolone use in hospitalised COVID-19 patients: a retrospective study |
| title_sort | methylprednisolone use in hospitalised covid 19 patients a retrospective study |
| topic | Methylprednisolone COVID-19 mortality outcome |
| url | https://www.tandfonline.com/doi/10.1080/20523211.2024.2337125 |
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