The impact of dexamethasone versus methylprednisolone upon neutrophil/lymphocyte ratio in COVID-19 patients admitted to ICU and its implication upon mortality

Soliman, Omar M; Moeen, Seham M.; Abbas, Yara H.; Kamel, Emad Zarief

doi:10.1080/11101849.2021.2024985

Cited by 10 publications

(32 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our search generated 4,178 publications. Finally, 16 trials were deemed eligible and included in the network meta-analysis ( Angus et al, 2020 , Corral-Gudino et al, 2021 , Dastenae et al, 2022 , Dequin et al, 2020 , Edalatifard et al, 2020 , Horby et al, 2021 , Jamaati et al, 2021 , Jeronimo et al, 2021 , Munch et al, 2021 , Ranjbar et al, 2021 , Salvarani et al, 2022 , Soliman et al, 2022 , Sterne et al, 2020 , Tang et al, 2021 , Tomazini et al, 2020 ). The publication screening process and a list of excluded studies with reasons for exclusion are summarized in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, eight studies were rated as having an overall “low risk of bias” ( Angus et al, 2020 , Dequin et al, 2020 , Horby et al, 2021 , Jeronimo et al, 2021 , Munch et al, 2021 , Ranjbar et al, 2021 , Salvarani et al, 2022 , Tomazini et al, 2020 ). The remaining studies were assessed as having an overall “high risk of bias” ( Corral-Gudino et al, 2021 , Dastenae et al, 2022 , Edalatifard et al, 2020 , Jamaati et al, 2021 , Soliman et al, 2022 , Sterne et al, 2020 , Tang et al, 2021 ). The high risk of bias was mainly due to the lack of blinding of outcome assessment.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of corticosteroids in patients with COVID-19: a Bayesian network meta-analysis

Wang¹,

Wen²,

He³

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effect of corticosteroids in patients with COVID-19: a Bayesian network meta-analysis

Wang¹,

Wen²,

He³

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

“…Several studies have revealed that compared with no glucocorticoid treatment, methylprednisolone also showed a mortality advantage in the treatment of severe COVID-19 [ 15 – 17 ]. Some researchers have compared the clinical effects of the two glucocorticoids during the current epidemic [ 18 – 29 ]. Nevertheless, the results are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of glucocorticoids treatment in severe COVID-19: methylprednisolone versus dexamethasone

Hong

Wang

et al. 2023

BMC Infect Dis

View full text Add to dashboard Cite

Objective The preferred agent of glucocorticoids in the treatment of patients with severe COVID-19 is still controversial. This study aimed to compare the efficacy and safety of methylprednisolone and dexamethasone in the treatment of patients with severe COVID-19. Methods By searching the electronic literature database including PubMed, Cochrane Central Register of Controlled Trials, and Web of Science, the clinical studies comparing methylprednisolone and dexamethasone in the treatment of severe COVID-19 were selected according to the inclusion criteria and exclusion criteria. Relevant data were extracted and literature quality was assessed. The primary outcome was short-term mortality. The secondary outcomes were the rates of ICU admission and mechanical ventilation, PaO2/FiO2 ratio, plasma levels of C-reactive protein (CRP), ferritin, and neutrophil/lymphocyte ratio, hospital stay, and the incidence of severe adverse events. Statistical pooling applied the fixed or random effects model and reported as risk ratio (RR) or mean difference (MD) with the corresponding 95% confidence interval (CI). Meta-analysis was performed using Review Manager 5.1.0. Results Twelve clinical studies were eligible, including three randomized controlled trials (RCTs) and nine non-RCTs. A total of 2506 patients with COVID-19 were analyzed, of which 1242 (49.6%) received methylprednisolone and 1264 (50.4%) received dexamethasone treatment. In general, the heterogeneity across studies was significant, and the equivalent doses of methylprednisolone were higher than that of dexamethasone. Our meta-analysis showed that methylprednisolone treatment in severe COVID-19 patients was related to significantly reduced plasma ferritin and neutrophil/lymphocyte ratio compared with dexamethasone, and that no significant difference in other clinical outcomes between the two groups was found. However, subgroup analyses of RCTs demonstrated that methylprednisolone treatment was associated with reduced short-term mortality, and decreased CRP level compared with dexamethasone. Moreover, subgroup analyses observed that severe COVID-19 patients treated with a moderate dose (2 mg/kg/day) of methylprednisolone were related to a better prognosis than those treated with dexamethasone. Conclusions This study showed that compared with dexamethasone, methylprednisolone could reduce the systemic inflammatory response in severe COVID-19, and its effect was equivalent to that of dexamethasone on other clinical outcomes. It should be noted that the equivalent dose of methylprednisolone used was higher. Based on the evidence of subgroup analyses of RCTs, methylprednisolone, preferably at a moderate dose, has an advantage over dexamethasone in the treatment of patients with severe COVID-19.

show abstract

“…Recent randomized controlled trials (RCTs) demonstrated the superiority of MP over DEXA in COVID-19. 9,10 Given the uncertainty of findings from the previous studies and meta-analyses on this topic, we conducted a systematic review and meta-analysis of RCTs only to improve the level of evidence and assess the efficacy and safety of MP and DEXA in patients with COVID-19.…”

mentioning

confidence: 99%

“…Three RCTs 5,9,10 with 560 patients (296 patients received MP and 264 received DEXA) were included. Characteristics and quality assessment of the included studies are summarized in Table 1.…”

mentioning

confidence: 99%

Methylprednisolone May Be Superior to Dexamethasone in COVID-19: A Meta-Analysis of Randomized Controlled Trials

Beran

Ayesh

Mhanna

et al. 2022

American Journal of Therapeutics

View full text Add to dashboard Cite

The impact of dexamethasone versus methylprednisolone upon neutrophil/lymphocyte ratio in COVID-19 patients admitted to ICU and its implication upon mortality

Cited by 10 publications

References 22 publications

Effect of corticosteroids in patients with COVID-19: a Bayesian network meta-analysis

Effect of corticosteroids in patients with COVID-19: a Bayesian network meta-analysis

A systematic review and meta-analysis of glucocorticoids treatment in severe COVID-19: methylprednisolone versus dexamethasone

Methylprednisolone May Be Superior to Dexamethasone in COVID-19: A Meta-Analysis of Randomized Controlled Trials

Contact Info

Product

Resources

About