Respiratory failure & ventilation
Intravenous methylprednisolone pulse therapy and the risk of in-hospital mortality among acute COVID-19 patients: Nationwide clinical cohort study
Authors' conclusion
The results of our study suggest that intravenous methylprednisolone showed dose-response efficiencies, and pulse therapy may benefit critically ill patients with acute COVID-19, such as those requiring iMV.
Study context
- Population
- Hospitalised acute COVID-19 patients at 438 hospitals in Japan, 2020–2021
- Participants
- 67,348 patients · 438 hospitals
- Exposure
- Pulse therapy vs Without methylprednisolone
- Outcome
- In-hospital mortality
Methodological detailsnationwide, multicentre, marginal structural model analysis
- Nationwide
- Multicentre
- Marginal structural model analysis
Main finding
As reported in the abstract
In-hospital mortality, stratified by iMV status
Hazard ratio (95% CI)
Pulse therapy (iMV) vs Without methylprednisolone (iMV)
0.59(0.52–0.68)
Pulse therapy (iMV-free) vs Without methylprednisolone (iMV-free)
3.38(3.02–3.79)
- Patients died during study period
- 2400
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| In-hospital mortality with intermediate/higher-dose methylprednisolone (40-250 mg IV), iMV-receiving patientsIntermediate/higher doses (iMV) vs Without methylprednisolone (iMV) · benefit of pulse therapy greater | 0.80 (0.71–0.89) | |
| 0.512Hazard ratio (log scale) |
Original publication
Intravenous methylprednisolone pulse therapy and the risk of in-hospital mortality among acute COVID-19 patients: Nationwide clinical cohort study. Crit Care. Published 8 February 2023. doi:10.
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