Methylprednisolone use in children with severe pneumonia caused by severe acute respiratory syndrome coronavirus 2
© 2023 Japan Pediatric Society..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
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| Enthalten in: |
Pediatrics international : official journal of the Japan Pediatric Society - 65(2023), 1 vom: 01. Jan., Seite e15603 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ozsurekci, Yasemin [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory distress syndrome (ARDS) |
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| Anmerkungen: |
Date Completed 02.11.2023 Date Revised 28.12.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1111/ped.15603 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM361137737 |
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| 520 | |a © 2023 Japan Pediatric Society. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Kesici, Selman |e verfasserin |4 aut | |
| 700 | 1 | |a Karakaya, Jale |e verfasserin |4 aut | |
| 700 | 1 | |a Cengiz, Ali Bulent |e verfasserin |4 aut | |
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