Corticosteroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials. Issue 20 (21st May 2021)

• Record Type: Journal Article
• Authors: Pulakurthi, Yashwitha Sai; Pederson, John M.; Saravu, Kavitha; Gupta, Nitin; Balasubramanian, Prasanth; Kamrowski, Shelby; Schmidt, Megan; Vegivinti, Charan Thej Reddy; Dibas, Mahmoud; Reierson, Natalie L.; Pisipati, Sailaja; Joseph, Betsy Ann; Selvan, Pragadeesh Thamarai; Dmytriw, Adam A.; Keesari, Praneeth Reddy; Sriram, Varsha; Chittajallu, Spandana; Brinjikji, Waleed; Katamreddy, Rewanth R.; Chibbar, Richa; Davis, Amber R.; Malpe, Manashree; Mishra, Hemant K.; Kallmes, Kevin M.; Hassan, Ameer E.; Evanson, Kirk W.
• Other Names: Săndulescu. Oana section editor.
• Is Part Of: Medicine. Volume 100:Issue 20(2021)
• Publication Date: 2021-05-21
• Subjects: adrenal cortex hormones -- coronavirus -- respiratory distress syndrome -- severe acute respiratory syndrome coronavirus-2; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000025719
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: Corticosteroid treatment is an effective and common therapeutic strategy for various inflammatory lung pathologies and may be an effective treatment for coronavirus disease 2019 (COVID-19). The purpose of this systematic review and meta-analysis of current literature was to investigate the clinical outcomes associated with corticosteroid treatment of COVID-19. Methods: We systematically searched PubMed, medRxiv, Web of Science, and Scopus databases through March 10, 2021 to identify randomized controlled trials (RCTs) that evaluated the effects of corticosteroid therapies for COVID-19 treatment. Outcomes of interest were mortality, need for mechanical ventilation, serious adverse events (SAEs), and superinfection. Results: A total of 7737 patients from 8 RCTs were included in the quantitative meta-analysis, of which 2795 (36.1%) patients received corticosteroids plus standard of care (SOC) while 4942 (63.9%) patients received placebo and/or SOC alone. The odds of mortality were significantly lower in patients that received corticosteroids as compared to SOC (odds ratio [OR] = 0.85 [95% CI: 0.76; 0.95], P = .003). Corticosteroid treatment reduced the odds of a need for mechanical ventilation as compared to SOC (OR = 0.76 [95% CI: 0.59; 0.97], P = .030). There was no significant difference between the corticosteroid and SOC groups with regards to SAEs and superinfections. Conclusion: Corticosteroid treatment can reduce the odds for mortality and the need for mechanical ventilation in severe COVID-19 patients. Abstract : Supplemental Digital Content is available in the text