Positive effects of methylprednisolone continuous infusion in treatment of hospitalized patients with COVID-19 associated bacterial pneumonia

Introduction. Hormones are traditionally not recommended in the presence of bacterial infection, as such use may lead in septic complications. However, we have found that early use of low to medium methylprednisolone doses in a specific administration mode we have developed on the basis of scientific publications and our own data may stop ARDS progression in hospitalized patients with COVID-19 associated bacterial pneumonia without complicating the bacterial process. The article looks into effects of methylprednisolone used in ‘bolus followed by continuous infusion’ mode within the complex therapy of COVID-19 associated bacterial pneumonia patients.
Materials and methods. We analyzed 37 patients admitted to our hospital during the 2nd and 3rd waves of COVID-19 at later stages of the disease, complicated by bacterial pneumonia. Apart from receiving comprehensive detoxication, anti-inflammatory, antibacterial and symptomatic therapy all patients received methylprednisolone used in ‘bolus followed by continuous infusion’ mode. The data was collected at two points and statistically analyzed. 
Results. Positive changes in all parameters were statistically significant, and none of the patient’s developed superinfection. Total survival was 86.49%, and none of the deaths was associated with septic complications. 
Conclusions. Our clinical observations and statistical analysis of data suggest that the early use of methylprednisolone in the ‘bolus followed by continuous infusion mode’ was associated with discontinuation of ARDS progression and did not lead to bacterial superinfection. On the contrary, bacterial infection regress was confirmed by the laboratory findings and statistically significant. Further research is needed for a detailed study of the results we here describe.

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