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Open Access

High-dose methylprednisolone versus dexamethasone therapy for hospitalized patients with severe COVID-19: a retrospective analysis

  • Yasumasa Kawano1,2,*,
  • Yusuke Osaki3
  • Hiroshi Yatsugi3
  • Tatsuya Hashimoto4
  • Naoko Inoshima5
  • Shuji Hayashi1,5

1Department of Emergency, Hakujyuji Hospital, 8198511 Fukuoka, Japan

2Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University Hospital, 8140180 Fukuoka, Japan

3Department of Respiratory Medicine, Hakujyuji Hospital, 8198511 Fukuoka, Japan

4Department of Surgery, Hakujyuji Hospital, 8198511 Fukuoka, Japan

5Department of Neurosurgery, Hakujyuji Hospital, 8198511 Fukuoka, Japan

DOI: 10.22514/sv.2022.065 Vol.19,Issue 3,May 2023 pp.50-56

Submitted: 10 May 2022 Accepted: 16 June 2022

Published: 08 May 2023

*Corresponding Author(s): Yasumasa Kawano E-mail:


This study aimed to evaluate the clinical effects of high-dose methylprednisolone therapy in hospitalized patients with severe coronavirus disease (COVID-19) who required oxygen therapy, but not noninvasive/invasive mechanical ventilation or extracorporeal membrane oxygenation therapy. This retrospective observational study that was conducted from April 2021 to October 2021 at a secondary hospital in Japan enrolled patients who were administered 6 mg/day dexamethasone as an initial corticosteroid treatment on admission (dexamethasone group) and those who were administered ≥ 250 mg/day methylprednisolone (methylprednisolone group). Of the 42 participants, 40.5%(17/42) were included in the methylprednisolone group. The incidence of transfer to a tertiary hospital did not differ significantly between the methylprednisolone and dexamethasone groups (5.9% vs. 20%, p = 0.37), and in-hospital mortality was similar in both the groups (0% vs. 4%, p = 1.00). Participants in the methylprednisolone group had a significantly longer duration of oxygen therapy than the dexamethasone group (median (interquartile range) 8.5 (5.5–11.2) days vs. 4 (2.0–7.5) days, p < 0.05). Compared to dexamethasone, high-dose methylprednisolone therapy did not provide any added benefits for patients with severe COVID-19 who did not require respiratory mechanical support.


COVID-19; Severe illness; Pulse; Methylprednisolone; Dexamethasone

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Yasumasa Kawano,Yusuke Osaki,Hiroshi Yatsugi,Tatsuya Hashimoto,Naoko Inoshima,Shuji Hayashi. High-dose methylprednisolone versus dexamethasone therapy for hospitalized patients with severe COVID-19: a retrospective analysis. Signa Vitae. 2023. 19(3);50-56.


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