Beneficial Effects of Pulse Methylprednisolone Therapy in COVID-19 Patients at Risk of Hyperinflammatory Response.

Publication date: Aug 01, 2025

Pulse methylprednisolone therapy can prevent cytokine storm in patients with severe COVID-19. The beneficial effects of pulse methylprednisolone therapy in terms of survival and duration of hospitalization in severe COVID-19 patients have not been explicitly demonstrated. Although prior studies have reported favorable outcomes, many were limited by small sample sizes, inconsistent steroid regimens, or lack of control groups. This study explicitly evaluates the efficacy of pulse methylprednisolone through matched-group comparison with well-defined biochemical and clinical endpoints. This study was performed to evaluate the efficacy of pulse methylprednisolone therapy in severe COVID-19 patients at risk of hyperinflammatory response. Efficacy was measured by early mortality (Day 3), discharge rate, peripheral capillary oxygen saturation improvement, oxygen requirement reduction, and changes in inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6; D-dimer; ferritin; and LDH). This was a retrospective observational study. Ninety patients with confirmed COVID-19, who were at risk of a hyperinflammatory response and had elevated serum inflammatory markers, as well as critically ill COVID-19 patients, were treated with pulse methylprednisolone therapy. This therapy involved administering doses of 125, 250, and >250 mg twice daily, tailored according to severity indicators and IL-6 thresholds, in addition to standard treatment for a duration of three days (Group A). Ninety age-, gender-, and disease severity-matched COVID-19 patients were taken as controls and were treated with standard treatment alone (Group B). The primary outcomes were the mortality rate at Day 3 and the duration of hospitalization. There were significant differences in the mortality rate at Day 3 (16. 7% vs. 52. 2%, p

Open Access PDF

Original Article