Comparison of Efficacy of Dexamethasone and Methylprednisolone in Improving the Partial Pressure of Arterial Oxygen and Fraction of Inspired Oxygen Ratio among COVID-19 Patients

Introduction The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), created a pandemic in late 2019. Acute respiratory distress syndrome can occur in patients with COVID-19 due to viral replication and an uncontrolled immune reaction. Therefore, antiviral and anti-inflammatory treatments are of particular interest to clinicians. We compared the efficacy of methylprednisolone and dexamethasone in reducing inflammation and improving the partial pressure of arterial oxygen and fraction of inspired oxygen (PaO2/FiO2 or P/F) ratio in COVID-19 patients. Methods We selected 60 files for this retrospective quasi-experimental study using a convenient sampling technique and divided them into two groups of 30 patients each who had received either dexamethasone or methylprednisolone. The data were taken from the medical records of the treated patients. Group 1 patients were given dexamethasone 8 mg twice daily, and Group 2 patients were given methylprednisolone 40 mg twice daily for eight days during their stay in our high dependency unit and our Intensive Care Unit. The remaining treatment was the same for both groups using antibiotics and anticoagulation. We reviewed C-reactive protein (CRP), serum ferritin level, and P/F ratio before and after the administration of both drugs for eight days. We used a paired t-test to assess the effectiveness of both drugs on the P/F ratio of participants. Results The initial mean CRP level of Group 1 was 110.34 mg/L, which decreased to 19.45 mg/L after administration of dexamethasone; similarly, the CRP of Group 2 was 108.65 mg/L, which decreased to 43.82 mg/L after administering methylprednisolone for eight days. Both dexamethasone and methylprednisolone significantly improved the P/F ratio (p<0.05), and dexamethasone was significantly more effective than methylprednisolone (p<0.05). Conclusion Steroids’ ability to reduce inflammation and suppress the immune response make them an effective tool in the treatment of COVID-19. Steroid therapy is effective in controlling inflammation markers, and, specifically, dexamethasone is effective in improving the P/F ratio in COVID-19 patients. Physicians should consider the use of dexamethasone use in appropriate patients with COVID-19.