Journal of Infectious Diseases and Diagnosis

Abstract

Methylene Blue in Treatment of Severe COVID-19 Patients: A Large Cohort Study

Bhanu Prakash Reddy Attunuru*, Madhusudhan Reddy Lingala, Podduturi Naveen Chander Reddy, Anand V Kulkarni, Sasikala Mitnala and Duvvur Nageshwar Reddy

Background and objectives: As there are limited treatment options in treatment severe COVID-19 disease we aim to evaluate the role of methylene blue in management of severe COVID-19 disease. The primary objective was to assess the survival benefit of methylene blue in severe COVID-19 disease. The secondary objective was to compare the duration of hospital stay, the requirement of invasive mechanical ventilation, the development of thrombotic complications and the change in inflammatory markers at discharge/death among the two groups. (SMT group and MB group).

Materials and methods: This is a single-center retrospective observational study of 362 patients admitted with severe COVID-19 disease from July 2020 to February 2021 in a tertiary care hospital during first wave of COVID-19 in India. 254 patients received MB at a dose of 1 mg/kg body weight intravenously for 5 days in addition to Standard Medical Therapy (SMT group) compared with 108 patients who received only SMT, which included remdesivir, low molecular weight heparin and systemic steroids.

Results: The length of hospital stay was shorter in the MB group (12.30 ± 7.106 days) than in the SMT group (14.33 ± 8.683; P=0.021). A similar number of patients developed thrombotic complications in both groups. Fewer patients in MB group required invasive mechanical ventilation (24.8% vs. 47.2% in SMT group; P=0.001). There was a significant reduction in the D-dimer (P=0.001) and ferritin levels (P=0.009) with MB. There was a significant mortality benefit with MB on Kaplan-Meier survival analysis. Mortality was 39.2% MB group and 59.3% in the SMT group (P=0.001).

Conclusion: The addition of methylene blue to standard medical therapy has been associated with a reduction in inhospital mortality, as well as a significant decrease in the length of hospital stay, inflammatory markers and the need for mechanical ventilation in patients with severe COVID-19.

Published Date: 2024-09-29; Received Date: 2022-04-16