Pulse Methylprednisolone Treatment in Adolescents With Severe COVID-19 Pneumonia

Background: Numerous studies have evaluated corticosteroid treatment in adults with severe COVID-19 pneumonia; however, data on pulse corticosteroid therapy in pediatric patients remain limited. Methods: Adolescent patients diagnosed with COVID-19 who received pulse methylprednisolone therapy for severe pneumonia were retrospectively evaluated. Results: Seven patients (3 females and 4 males) with severe COVID-19 pneumonia were included. The median age was 16 years. According to World Health Organization criteria, 2 patients were overweight and 5 were obese. Four patients had underlying comorbid conditions. Six patients presented with dyspnea (tachypnea and/or chest retractions) at admission, and 1 patient developed dyspnea during hospitalization. All patients had oxygen saturation levels below 92%. Extensive pulmonary infiltrates were observed on chest imaging in all patients. Three patients required admission to the intensive care unit, and 2 required invasive mechanical ventilation. One patient developed hyperglycemia, which resolved without the need for insulin therapy. No other corticosteroid-related adverse effects were observed. One patient died; all remaining patients recovered. The mean duration of hospitalization among surviving patients was 13 ± 4.6 days. Conclusions: Rapid clinical improvement was observed after pulse corticosteroid therapy in adolescents with severe COVID-19 pneumonia. No significant adverse effects related to pulse corticosteroid treatment were identified in this cohort.