Comparison of high-dose, short-term steroid and low-dose long-term steroid use in ARDS caused by COVID-19: Retrospective cohort study

Abstract

Background/Aim: Given the increasing incidence and mortality caused by coronavirus 2019 ( COVID-19) worldwide, beneficial and effective treatment for patients in the early pulmonary phase is still of great importance. Fifteen-day continuous hemodynamic, laboratory, and clinical courses of patients with acute respiratory distress syndrome (ARDS) due to COVID-19 who received short-term high-dose and long-term low-dose systemic methylprednisolone were compared. Methods: Two hundred and two patients were reported to have ARDS due to COVID-19 in the intensive care unit between June 1, 2020 and February 1, 2021. The patients were divided into two groups: (1) short-term high-dose and (2) long-term low-dose systemic methylprednisolone. Age, gender, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, steroid treatment protocol, intubation duration, length of stay (LOS), Neutrophil/Lymphocyte Ratio, C-reactive protein (CRP), procalcitonin, lactate levels, cytokine filter requirements, the prognosis, and total costs were obtained from their records. Results: It was determined that elderly patients tended to be given low doses of steroids. No significant differences between the two treatment protocols in terms of other parameters were found. It was determined that high doses of steroids affected only CRP levels (P<0.05). Conclusion: No differences in lactate, PCT levels, NLR, intubation and weaning times, hemoperfusion requirements, hospital stay, and prognosis between administration of different doses and durations of methylprednisolone for the treatment of COVID-19 ARDS were found.