Comparison of clinical outcomes between dexamethasone-containing and dexamethasone-free drug regimens in the treatment of elderly patients with COVID-19: A retrospective cohort study

Mohammadrezaei Khorramabadi, Rezvan; Azadi, Abbas; ,; Birjandi, Mehdi; Shokri, Shahram

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Comparison of clinical outcomes between dexamethasone-containing and dexamethasone-free drug regimens in the treatment of elderly patients with COVID-19: A retrospective cohort study

Rezvan Mohammadrezaei Khorramabadi

, Abbas Azadi

, Mehdi Birjandi

, Shahram Shokri

Abstract: (262 Views)

Background and Aim: The severe disease course of COVID-19 in elderly individuals, particularly those with comorbidities, and their associated higher mortality, has prompted clinicians to employ various drug regimens for treatment. This study aimed to compare the clinical outcomes of therapeutic regimens containing dexamethasone versus those without dexamethasone in elderly patients diagnosed with COVID-19.
Methods: In this retrospective cohort study, data were collected via a complete census from the medical records of all elderly patients with COVID-19 admitted to teaching hospitals in Khorramabad from the beginning of the pandemic until January 2021. The research instrument was a researcher-constructed questionnaire encompassing demographic information, symptoms, and treatment outcomes. Data were analyzed using Chi-square, Mann-Whitney U, and independent samples t-tests by SPSS software version 21.
Results: A total of 900 records were reviewed, of which 49.1% pertained to male elderly patients. The five therapeutic regimens were homogeneous concerning the variables of age, gender, tobacco use, body mass index (BMI), medical history, type of comorbidity, PCR test result, and disease recurrence/re-admission (P > 0.05). The use of dexamethasone was associated with a significant reduction in transfer to the intensive care unit and a shorter duration of hospitalization (P < 0.001). However, no statistically significant difference was observed between the two groups regarding mortality rate or the need for respiratory support (P > 0.05). Furthermore, dexamethasone-containing regimens significantly reduced disease severity (P < 0.001).
Conclusion: The use of drug regimens containing dexamethasone in hospitalized elderly patients with COVID-19 appears to be effective in reducing disease severity, the need for ICU admission, and the length of hospital stay; however, it does not seem to affect the ultimate disease outcome (mortality). Further controlled studies are recommended to confirm these findings.

Keywords: COVID-19, Aged, Therapeutic regimen, Disease outcome, Corticosteroids

Type of Study: Research | Subject: medicine, paraclinic
Received: 2025/04/11 | Revised: 2025/11/2 | Accepted: 2025/10/12

References

1. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses. 2020; 12(4):372. doi.10.3390/v12040372 PMid:32230900 PMCid:PMC7232198

2. Chan JF-W, Yuan S, Chu H, Sridhar S, Yuen K-Y. COVID-19 drug discovery and treatment options. Nat Rev Microbiol. 2024; 22(7):391-407. doi.10.1038/s41579-024-01036-y PMid:38622352

3. Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT. Coronavirus disease (COVID-19): comprehensive review of clinical presentation. Front Public Health. 2021; 8:582932. doi.10.3389/fpubh.2020.582932 PMid:33520910 PMCid:PMC7844320

4. Sethi I, Shaikh A, Sethi M, Chohan HK, Younus S, Khan SA, et al. Dosage and utilization of dexamethasone in the management of COVID-19: A critical review. World J Virol. 2024; 13(3):95709. doi.10.5501/wjv.v13.i3.95709

5. Russell L, Uhre KR, Lindgaard ALS, Degn JF, Wetterslev M, Sivapalan P, et al. Effect of 12 mg vs 6 mg of dexamethasone on the number of days alive without life support in adults with COVID-19 and severe hypoxemia: the COVID STEROID 2 randomized trial. JAMA. 2021; 326(18):1807-17. doi.10.1001/jama.2021.18295 PMid:34673895 PMCid:PMC8532039

6. Maskin LP, Bonelli I, Olarte GL, Palizas Jr F, Velo AE, Lurbet MF, et al. High-versus low-dose dexamethasone for the treatment of COVID-19-related acute respiratory distress syndrome: a multicenter, randomized open-label clinical trial. J Intensive Care Med. 2022; 37(4):491-9. doi.10.1177/08850666211066799 PMid:34898320 PMCid:PMC8926919

7. Abani O, Abbas A, Abbas F, Abbas J, Abbas K, Abbas M, et al. Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2023; 401(10387):1499-507. doi.10.1016/S0140-6736(23)00510-X PMid:37060915

8. Toroghi N, Abbasian L, Nourian A, Davoudi-Monfared E, Khalili H, Hasannezhad M, et al. Comparing efficacy and safety of different doses of dexamethasone in the treatment of COVID-19: a three-arm randomized clinical trial. Pharmacol Rep. 2022; 74(1):229-40. doi.10.1007/s43440-021-00341-0 PMid:34837648 PMCid:PMC8627167

9. Wu H, Daouk S, Kebbe J, Chaudry F, Harper J, Brown B. Low-dose versus high-dose dexamethasone for hospitalized patients with COVID-19 pneumonia: a randomized clinical trial. PLoS One. 2022; 17(10):e0275217. doi.10.1371/journal.pone.0275217 PMid:36190994 PMCid:PMC9529091

10. Modig K, Lambe M, Ahlbom A, Ebeling M. Excess mortality for men and women above age 70 according to level of care during the first wave of COVID-19 pandemic in Sweden: a population-based study. Lancet Reg Health Eur. 2021; 4: 100072. doi.10.1016/j.lanepe.2021.100072 PMid:34557812 PMCid:PMC8454796

11. Bencivenga L, Rengo G, Varricchi G. Elderly at time of CoronaVirus disease 2019 (COVID-19): possible role of immunosenescence and malnutrition. Geroscience. 2020;42(4):1089-92. doi.10.1007/s11357-020-00218-9 PMid:32578073 PMCid:PMC7308600

12. Peterfi A, Meszaros A, Szarvas Z, Penzes M, Fekete M, Feher A, et al. Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review. Physiol Int. 2023; 109(4):441-54. doi.10.1556/2060.2022.00206 PMid:35575986

13. Bartleson JM, Radenkovic D, Covarrubias AJ, Furman D, Winer DA, Verdin E. SARS-CoV-2, COVID-19 and the aging immune system. Nat Aging. 2021; 1(9):769-82. doi.10.1038/s43587-021-00114-7 PMid:34746804 PMCid:PMC8570568

14. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020; 12(13): 12493-503. doi.10.18632/aging.103579 PMid:32658868 PMCid:PMC7377860

15. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380(9836): 37-43. doi.10.1016/S0140-6736(12)60240-2 PMid:22579043

16. Nikolich-Zugich J, Knox KS, Rios CT, Natt B, Bhattacharya D, Fain MJ. SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes. Geroscience. 2020; 42(2):505-14. doi.10.1007/s11357-020-00186-0 PMid:32274617 PMCid:PMC7145538

17. Sabetsarvestani P, Rahnavard S, Hatami M, Bijani M, Nikrooz L. Investigating the Demographic Characteristics, Clinical Signs, Radiological and Laboratory Findings in Pregnant Women with COVID-19: A Cross-Sectional Study in Southern Iran. Avicenna J Nurs Midwifery Care. 2021; 29(3):256-63. doi.10.30699/ajnmc.29.3.256

18. Coelho L, Falcao F, Póvoa P, Viegas E, Martins AP, Carmo E, et al. Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients. Sci Rep. 2023; 13(1):4482. doi.10.1038/s41598-023-31544-5 PMid:36934143 PMCid:PMC10024012

19. Mehraeen E, SeyedAlinaghi S, Saeidi S, Heydari M. Identifying the self-care instructions for Patients with coronavirus not requiring hospitalization during the COVID-19 pandemic. RJMS. 2021; 27(11):72-82.

20. Horby P, Lim WS, Emberson J, Mafham M, Bell J, Linsell L, et al. Effect of dexamethasone in hospitalized patients with COVID-19-preliminary report. medRxiv. 2020:2020.06.22.20137273. doi.10.1101/2020.06.22.20137273

21. Ho KS, Narasimhan B, Difabrizio L, Rogers L, Bose S, Li L, et al. Impact of corticosteroids in hospitalised COVID-19 patients. BMJ Open Respir Res. 2021; 8(1):e000766. doi.10.1136/bmjresp-2020-000766 PMid:33811098 PMCid:PMC8023732

22. Reyes LF, Rodriguez A, Bastidas A, Parra-Tanoux D, Fuentes YV, García-Gallo E, et al. Dexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19. J Crit Care. 2022;69:154014. doi.10.1016/j.jcrc.2022.154014 PMid:35217370 PMCid:PMC8863516

23. Li YM, Meng Q, Rao X, Wang B, Zhang X, Dong F, et al. Corticosteroid therapy in critically ill patients with COVID-19: a multicenter, retrospective study. Crit Care. 2020; 24(1):698. doi.10.1186/s13054-020-03429-w PMid:33339536 PMCid:PMC7747001

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