Comparison of efficacy of dexamethasone and methylprednisolone in moderate to severe COVID 19 disease

Abstract

Background The first case of Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were diagnosed in Wuhan, China in 2019. In the first half of 2020 this disease has already converted into a global pandemic. Various treatment options were being tried all over the world. Some studies showed beneficial effects of corticosteroids in covid 19. Hence, we designed this study to compare the effect of two steroids in moderate to severe covid 19 disease. Objectives To compare the efficacy and safety of dexamethasone and methylprednisolone in moderate to severe covid 19 disease. Study Settings Fatima Memorial Hospital, Lahore and Ganga Ram hospital, Lahore. Study Design Quasi experimental, interventional study. Duration of Study From 1st June 2020 to 30th June 2020. Methodology Sample size and technique: there were total 100 patients; 35 patients received dexamethasone and 65 were kept in methylprednisolone receiving group. Results The mean age of patients was 57.91 years in dexamethasone group and 54.86 years in methylprednisolone group. In dexamethasone group, there were 15 (42.8%) critically ill patients who were shifted to Intensive care unit (ICU) and seven (20%) of them needed ventilatory support, whereas in methylprednisolone group 22 (33.8%) had to be admitted in ICU with eight (12.3%) patient needing ventilator. As outcome measure, patients in both the groups showed marked improvement in temperature, oxygen requirement and C-reactive protein (CRP) on day 5. Only six (17.1%) patient died who received dexamethasone while 10 (15.3%) patients died among those receiving methylprednisolone. Conclusion Dexamethasone and methylprednisolone both are equally effective in treating moderate to severe covid 19 disease.