Medical Evidence

Methylprednisolone (Corticosteroids)

Corticosteroid therapy is one of the most effective interventions in COVID-19 and MATH+. From early March 2020, when the FLCCC team of physicians first came together to study and create treatment protocols for fighting the novel disease, the team, guided by Dr. G. Umberto Meduris expertise in corticosteroid use, placed methylprednisolone at the head  as the M  in its MATH+ hospital treatment formula.  As a result, the two hospitals using the MATH+ formula had mortality rates of no higher than 6%, when most hospitals lost as many as 80% of their seriously ill COVID patients.  This was months before the landmark RECOVERY trial convinced world authorities to allow and advocate for the use of steroids in treating the inflammatory stage of the disease.  Publications listed below range from large scale observational studies demonstrating large impacts on mortality in the prior pandemics of SARS and H1N1, through the landmark RECOVERY trial done in the United Kingdom against COVID-19, to numerous and increasing COVID-19 retrospective cohort studies published from Italy, China, Spain, and the United States. In addition, a scientific review of the evidence supporting methylprednisolone in COVID-19 authored by FLCCC Alliance member Dr. G. Umberto Meduri can be found here.

October 7, 2020 | Springer
The ten reasons why corticosteroid therapy reduces mortality in severe COVID-19
Yaseen M. Arabi, George P. Chrousos & G. Umberto Meduri
https://link.springer.com/article/10.1007/s00134-020-06223-y

September 22, 2020 | USA (BMJ Open Respiratory Research)
SARS-CoV-2 organising pneumonia: ‘Has there been a widespread failure to identify and treat this prevalent condition in COVID-19?’
Pierre Kory (FLCCC Alliance) and Jeffrey P. Kanne
https://bmjopenrespres.bmj.com/content/7/1/e000724.full

September 12 | Open Forum Infectious Diseases
Prolonged Low-Dose Methylprednisolone in Patients With Severe COVID-19 Pneumonia
Francesco Salton, Paola Confalonieri, G. Umberto Meduri et al.
https://doi.org/10.1093/ofid/ofaa421

September 2, 2020 | USA
Timing is crucial and hydrocortisone should be started within the first 12 hours after shock onset
Cohort study: “Evaluation of the Initiation Timing of Hydrocortisone in Adult Patients With Septic Shock”
http://doi.org/10.1097/SHK.0000000000001651

September 2, 2020 | worldwide
Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19
The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial
https://jamanetwork.com/journals/jama/fullarticle/2770278?utm_campaign=articlePDF

September 2, 2020 | France
Effect of hydrocortisone on 21-day mortality or respiratory support among critically ill patients with COVID-19
A Randomized Clinical Trial
https://jamanetwork.com/journals/jama/fullarticle/2770276tm_medium=articlePDFlink&utm_source=ar…

September 2, 2020 | Brazil
Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19
The CoDEX Randomized Clinical Trial
https://jamanetwork.com/journals/jama/fullarticle/2770277

June 25, 2020 | Italy/USA/UK
Treatment with Methylprednisolone leads to significant mortality reduction in COVID-19
“Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia” (Clinical Trial)
https://doi.org/10.1101/2020.06.17.20134031

June 18, 2020 | Spain
Methylprednisolone decreases risk of ICU, NIV, or death in Covid-19
“GLUCOCOVID: A controlled trial of methylprednisolone in adults hospitalized with COVID-19 pneumonia” (Clinical Trial)
https://doi.org/10.1101/2020.06.17.20133579

May 19, 2020 | USA
Early CST (corticosteroid treatment) reduces mortality, need for ICU beds, ventilators in COVID-19
“Early short course corticosteroids in hospitalized patients with COVID-19” (Multi-center quasi-experimental study)
https://doi.org/10.1093/cid/ciaa601

May 15, 2020 | USA
Methylprednisolone counteracts SARS-CoV-2 gene activation pattern
“COVID-19: disease pathways and gene expression changes predict methylprednisolone can improve outcome in severe cases” (Clinical Study)
https://dx.doi.org/10.21203/rs.3.rs-29392/v1

May 13, 2020 | France
CST reduces the risk of intubation in COVID-19 patients
“Beneficial effect of corticosteroids in severe COVID-19 pneumonia: A propensity score matching analysis” (Case-control Study)
https://doi.org/10.1101/2020.05.08.20094755

April 28, 2020 | Spain/Italy et al.
CST reduced mortality during SARS and H1N1 pandemics
“Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019”
https://doi.org/10.1097/cce.0000000000000111

April 28, 2020 | China
Early CST reduces need for mechanical ventilation, ICU and hospital LOS, and oxygen support
“A retrospective cohort study of methylprednisolone therapy in severe patients with COVID-19 pneumonia”
https://doi.org/10.1038/s41392-020-0158-2

April 22, 2020 | USA/Greece
The role of Glucocorticoid receptors in critical illness
“General Adaptation in Critical Illness: Glucocorticoid Receptor-alpha Master Regulator of Homeostatic Corrections”
https://doi.org/10.3389/fendo.2020.00161

April 20, 2020 | USA
Timed & titrated use of steroid in COVID-19?
Josh Farkas of PulmCrit reviews need for steroids in COVID-19
https://emcrit.org/pulmcrit/steroid-covid/

April 2020 | Critical Care Explorations
Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019
Jesús Villar, Marco Confalonieri, Stephen M. Pastores, G. Umberto Meduri
http://doi.org/10.1097/CCE.0000000000000111

March 13, 2020 | China
CST in COVID ARDS associated with lower mortality
“Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China” (Cohort Study)
https://doi.org/10.1001/jamainternmed.2020.0994