Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 30:8:758405.
doi: 10.3389/fmed.2021.758405. eCollection 2021.

Short-Course of Methylprednisolone Improves Respiratory Functional Parameters After 120 Days in Hospitalized COVID-19 Patients (Metcovid Trial): A Randomized Clinical Trial

Camila Miriam Suemi Sato Barros  1   2 , Raissa Soares Freire  1   2 , Elisângela Frota  1   2 , Anna Gabriela Rezende Santos  1   3 , Maria Eduarda Leão Farias  4 , Maria Gabriela Almeida Rodrigues  1   2 , Bernardo Maia Silva  1   2 , Christiane Maria Prado Jeronimo  1   2 , Rebeca Linhares Abreu Netto  1   2 , Mayla Gabriela Silva Borba  1   2 , Djane Baía-da-Silva  1   2 , José Diego Brito-Sousa  1   2 , Mariana Simão Xavier  5 , Marcia Almeida Araújo-Alexandre  1 , Vanderson Souza Sampaio  1   2   6 , Gisely Cardoso Melo  1   2 , Guilherme Tinoco Arêas  7 , Ludhmila Abrahão Hajjar  8 , Wuelton Marcelo Monteiro  1   2 , Felipe Gomes Naveca  4 , Fábio Trindade Maranhão Costa  9 , Fernando Fonseca Almeida Val  1   2   3 , Marcus Vinícius Guimarães Lacerda  1   2   4 ; Metcovid team
Collaborators, Affiliations

Short-Course of Methylprednisolone Improves Respiratory Functional Parameters After 120 Days in Hospitalized COVID-19 Patients (Metcovid Trial): A Randomized Clinical Trial

Camila Miriam Suemi Sato Barros et al. Front Med (Lausanne). .

Abstract

Background: The use of corticosteroids may help control the cytokine storm occurring in acute respiratory failure due to the severe form of COVID-19. We evaluated the postacute effect of corticosteroids used during the acute phase, such as impairment in pulmonary function parameters, on day 120 (D120)-follow-up, in participants who survived over 28 days. Methods: This is a parallel, double-blind, randomized, placebo-controlled phase IIb clinical trial carried out between April 18 and October 9, 2020, conducted in hospitalized patients with clinical-radiological suspicion of COVID-19, aged 18 years or older, with SpO2 ≤ 94% on room air or requiring supplementary oxygen, or under invasive mechanical ventilation (IMV) in a referral center in Manaus, Western Brazilian Amazon. Intravenous methylprednisolone (MP) (0.5 mg/kg) was given two times daily for 5 days to these patients. The primary outcome used for this study was pulmonary function testing at day 120 follow-up visit. Results: Out of the total of surviving patients at day 28 (n = 246) from the Metcovid study, a total of 118 underwent satisfactory pulmonary function testing (62 in the placebo arm and 56 in the MP arm). The supportive treatment was similar between the placebo and MP groups (seven [11%] vs. four [7%]; P = 0.45). At hospital admission, IL-6 levels were higher in the MP group (P < 0.01). Also, the need for ICU (P = 0.06), need for IMV (P = 0.07), and creatine kinase (P = 0.05) on admission also tended to be higher in this group. In the univariate analysis, forced expiratory volume on 1st second of exhalation (FEV1) and forced vital capacity (FVC) at D120 follow-up were significantly higher in patients in the MP arm, being this last parameter also significantly higher in the multivariate analysis independently of IMV and IL-6 levels on admission. Conclusion: The use of steroids for at least 5 days in severe COVID-19 was associated with a higher FVC, which suggests that hospitalized COVID-19 patients might benefit from the use of MP in its use in the long-term, with less pulmonary restrictive functions, attributed to fibrosis. Trial Registration: ClinicalTrials.gov, Identifier: NCT04343729.

Keywords: Brazil; COVID-19; SARS-CoV-2; coronavirus; corticosteroid; inflammation; long-covid; pulmonary function test.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart of the Metcovid trial survivors who performed pulmonary function test.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, et al. . Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. (2020) 20:669–77. 10.1016/S1473-3099(20)30243-7 - DOI - PMC - PubMed
    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. (2020) 395:1054–62. 10.1016/S0140-6736(20)30566-3 - DOI - PMC - PubMed
    1. Wang C, Xie J, Zhao L, Fei X, Zhang H, Tan Y, et al. . Alveolar macrophage dysfunction and cytokine storm in the pathogenesis of two severe COVID-19 patients. EBioMedicine. (2020) 57:102833. 10.1016/j.ebiom.2020.102833 - DOI - PMC - PubMed
    1. Dhont S, Derom E, Van Braeckel E, Depuydt P, Lambrecht BN. The pathophysiology of “happy” hypoxemia in COVID-19. Respir Res. (2020) 21:1–9. 10.1186/s12931-020-01462-5 - DOI - PMC - PubMed
    1. Wang F, Kream RM, Stefano GB. Long-Term Respiratory and Neurological Sequelae of COVID-19. Med Sci Monit. (2020) 26:e928996. 10.12659/MSM.928996 - DOI - PMC - PubMed

Associated data