Trial reportBMC pulmonary medicine2025
Early C-reactive protein reduction predicts survival in COVID-19 severe pneumonia treated with glucocorticoids.
Trial report in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04636671 (Randomized Controlled Trial of Methylprednisolone Versus Dexamethasone in COVID-19 Pneumonia), which is not on this map. Cited by 1 paper.
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)
Who cites it
1 citing paper in PubMed.
- Association between albumin-based nutritional inflammation indices and all-cause mortality in patients with severe pneumonia.BMC infectious diseases · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundprolonged, low-dose glucocorticoid treatment reduces systemic inflammation and mortality in patients with SARS-CoV-2-related pneumonia requiring respiratory support. Previous studies reported a significant C-reactive protein (CRP) reduction in the early days of treatment compared to placebo. While CRP is an independent predictor of severity in community-acquired pneumonia, there is no evidence on the correlation between CRP changes and mortality within a glucocorticoid-treated population.
methodsdata from the MEDEAS randomized controlled trial were re-analyzed as a single cohort of patients with SARS-CoV-2-related pneumonia undergoing either dexamethasone 6 mg/day for 10 days or methylprednisolone 80 mg/day for ≥ 8 days from hospitalization. CRP relative decrease between treatment initiation and day 3 was calculated and tested to predict 28-day mortality. Additionally, clinically relevant CRP percentage changes by day 3 were calculated and tested to predict survival. A stratification was performed for baseline PaO
results597 patients were included in the analysis. In multivariable logistic regression analysis, the relative decrease in CRP by day 3 was significantly associated with 28-day survival (OR 0.77; 95%CI 0.64-0.99; p = 0.011). Furthermore, a ≥ 5% CRP reduction was associated with a lower mortality compared to either < 5% reduction or any increase in CRP levels by day 3 (8.2% versus 18.5%; OR 0.40; 95%CI 0.23-0.69; p = 0.001) in the whole cohort. When stratifying for baseline PaO
conclusionsin patients with COVID-19-related severe pneumonia receiving low-dose glucocorticoid treatment, even early reductions in CRP levels, together with other meaningful clinical traits, predict survival, representing a possible biomarker to guide personalized interventions.
trial registrationThe MEDEAS randomized controlled trial was registered on ClinicalTrials.gov on 18 November 2020 (NCT04636671).
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