ArticleOpen forum infectious diseases2020
Prolonged Low-Dose Methylprednisolone in Patients With Severe COVID-19 Pneumonia.
Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 97 papers, 14 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Controlled Trial of Methylprednisolone Versus Dexamethasone in COVID-19 Pneumonia (MEDEAS Trial)
Randomized Controlled Trial on the Efficacy of Dexamethasone Versus Methyl Prednisolone in Covid-19 Infected Patients With High Oxygen Flow
Who cites it
97 citing papers in PubMed, 14 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- The role of methylprednisolone in severe COVID-19 patients: a meta-analysis.Frontiers in medicine · 2024Pooled it
- Effect of corticosteroid therapy on mortality in COVID-19 patients-A systematic review and meta-analysis.Reviews in medical virology · 2022Pooled it
- The roles of methylprednisolone treatment in patients with COVID-19: A systematic review and meta-analysis.Steroids · 2022Pooled it
- Effects of corticosteroids on Covid-19 patients: A systematic review and meta-analysis on clinical outcomes.Pulmonary pharmacology & therapeutics · 2022Pooled it
- Use of steroids in COVID-19 patients: A meta-analysis.European journal of pharmacology · 2022Pooled it
- Effects of Tocilizumab on Adults With COVID-19 Pneumonia: A Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Effects of different corticosteroid therapy on severe COVID-19 patients: a meta-analysis of randomized controlled trials.Expert review of respiratory medicine · 2022Pooled it
- Coronavirus Disease 2019 as Cause of Viral Sepsis: A Systematic Review and Meta-Analysis.Critical care medicine · 2021Pooled it
- Pre-existing interstitial lung disease in patients with coronavirus disease 2019: A meta-analysis.International immunopharmacology · 2021Pooled it
- The association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review with Bayesian meta-analyses (version 7).Addiction (Abingdon, England) · 2021Pooled it
- Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes.Critical care (London, England) · 2020Pooled it
- Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.Journal of infection and public health · 2020Pooled it
- Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version).Military Medical Research · 2020Guideline
- Efficacy and safety of steroid therapy in COVID-19: A rapid systematic review and Meta-analysis.Indian journal of pharmacologyPooled it
- Early C-reactive protein reduction predicts survival in COVID-19 severe pneumonia treated with glucocorticoids.BMC pulmonary medicine · 2025Trial
- Prolonged higher dose methylprednisoloneThe European respiratory journal · 2023Trial
- Trial
- Clinical Phenotypes of Critically Ill Patients with COVID-19 Infected with Omicron: A Nationwide Prospective Cohort Study.Infectious diseases and therapy · 2026Article
- Existence and relevance of fulminant severe community-acquired pneumonia.Pneumonia (Nathan Qld.) · 2025Article
- A meta-analysis of the efficacy and safety of immunomodulators in the treatment of severe COVID-19.The Journal of international medical research · 2025Article
37 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
45 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for intensive care unit (ICU) admission and mortality.
methodsWe conducted a multicenter observational study to explore the association between exposure to prolonged, low-dose MP treatment and need for ICU referral, intubation, or death within 28 days (composite primary end point) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units. Secondary outcomes were invasive MV-free days and changes in C-reactive protein (CRP) levels.
resultsFindings are reported as MP (n = 83) vs control (n = 90). The composite primary end point was met by 19 vs 40 (adjusted hazard ratio [aHR], 0.41; 95% CI, 0.24-0.72). Transfer to ICU and invasive MV were necessary in 15 vs 27 (
conclusionIn patients with severe COVID-19 pneumonia, early administration of prolonged MP treatment was associated with a significantly lower hazard of death (71%) and decreased ventilator dependence. Treatment was safe and did not impact viral clearance. A large randomized controlled trial (RECOVERY trial) has been performed that validates these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.