Comparative 28-day Outcomes of Pulse-Dose Methylprednisolone versus Prolonged Low-Dose Dexamethasone in Hospitalized COVID-19 Pneumonia: A Cohort Study.
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Corticosteroids are widely used in COVID-19 pneumonia; however, the optimal regimen remains uncertain. We compared clinical outcomes between pulse-dose methylprednisolone and prolonged low-dose dexamethasone in hospitalized patients with COVID-19 pneumonia. Methods: In this retrospective cohort study, adult patients hospitalized with COVID-19 pneumonia (18 April-30 August 2021), who received either pulse-dose methylprednisolone or prolonged low-dose dexamethasone, were compared regarding 28-day mortality, in-hospital mortality, and treatment-free days. Multivariable Cox regression and propensity score matching (PSM) were used to adjust for confounding. Results: Among 460 patients (269 pulse-dose methylprednisolone, 191 prolonged low-dose dexamethasone), no significant difference in 28-day mortality was observed in multivariable analysis (aHR: 1.51; 95% CI: 0.74-3.09, p = 0.26). After PSM, 28-day mortality remained similar (HR: 1.40; 95% CI: 0.64-3.06; p = 0.38), although a trend toward higher in-hospital mortality was noted with pulse-dose methylprednisolone (HR: 2.07; 95% CI: 0.96-4.42; p = 0.06). Conclusion: Pulse-dose methylprednisolone was not associated with a significant difference in 28-day mortality compared with prolonged low-dose dexamethasone. A trend toward higher in-hospital mortality was observed with pulse-dose methylprednisolone, warranting cautious interpretation due to potential residual confounding.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213338875