Dexamethasone Vs methylprednisolone In treating Covid-19 pneumonia: A meta-analysis of randomized trials

Abstract

Background: systemic corticosteroids have demonstrated definite mortality benefit in management of COVID 19 in various studies. Still certain questions regarding the appropriate dose, duration and timing of corticosteroids remain unanswered. For this reason, the study was planned to determine the efficacy and safety of methyl prednisolone in management of COVID 19 from publicly available evidence. Objectives: To compare between dexamethasone and methylprednisolone in treating Covid-19 pneumonia patients with respiratory failure. Study design: Meta-analysis was used to address this concern. Sittings: Meta-analysis-based study following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines. Methods: Online databases (PubMed, Embase, BioMed, and the Cochrane Central Register of Controlled trials) were used for randomized studies ever performed in humans in any clinical setting. Results: Ten studies were identified for inclusion in this study, involving a total of 1812 patients. The risk of bias was low. Meta-analysis found that methylprednisolone result in significant decrease in hospital length of stay, ventilatory need and mortality. Conclusion: Our meta-analysis found that methylprednisolone has the potential to improve the prognosis of patients with severe COVID-19 pneumonia, in comparison to dexamethasone.