Efficacy of High‐Dose Versus Conventional‐Dose Methylprednisolone in Reducing the Risk of Chronic Lung Disease in Chinese Children With Severe Mycoplasma pneumoniae Pneumonia: A Retrospective Study

BACKGROUND: This study aimed to compare the clinical efficacy of high-dose versus conventional-dose methylprednisolone therapy and the prevalence of chronic lung disease (CLD) at the 6-month follow-up in Chinese children with severe Mycoplasma pneumoniae pneumonia (SMPP). METHODS: A retrospective cohort study was performed on 82 children with SMPP admitted from January 2018 to January 2024. Patients were categorized into high-dose and conventional-dose groups based on initial glucocorticoid dosage. Clinical data, laboratory tests, chest imaging, and bronchoscopy findings were reviewed to compare pulmonary conditions and therapeutic efficacy. The prevalence of CLD, oxygen saturation levels, and pulmonary function were assessed at the 6-month follow-up. RESULTS: The main clinical features of SMPP included persistent high fever, cough, excessive inflammation (C-reactive protein, erythrocyte sedimentation rate, procalcitonin, interleukin-6, lactate dehydrogenase, serum ferritin, and D-Dimer), as well as severe pulmonary involvement, including consolidation, pleural effusion, and lung necrosis on computed tomography, and mucus plugging on bronchoscopy. Disease severity was comparable between groups, but the high-dose group exhibited a shorter fever duration (9.8 vs. 16.1 days), faster defervescence after corticosteroid treatment (1.0 vs. 7.0 days), and reduced hospitalization (13.4 vs. 18.4 days) (all p < 0.001). At the 6-month follow-up, the high-dose group had a significantly lower prevalence of CLD (28.2% vs. 85.4%) (p < 0.001), higher oxygen saturation levels (p = 0.033) and better pulmonary function (p < 0.001). CONCLUSION: High-dose methylprednisolone therapy was more effective than conventional-dose treatment for SMPP patients. It was also associated with a lower prevalence of CLD, higher oxygen saturation levels, and better pulmonary function outcomes.