Effects of different corticosteroid therapy on severe COVID-19 patients: a meta-analysis of randomized controlled trials
| العنوان: | Effects of different corticosteroid therapy on severe COVID-19 patients: a meta-analysis of randomized controlled trials |
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| المؤلفون: | Tian Xie, Xiaoqiao Mo, Yun Liu, Wenhua Jing, Jing Xun, Jiayuan Tu, Xiangda Zhang, Xueshun Chen |
| المصدر: | Expert Review of Respiratory Medicine article-version (VoR) Version of Record |
| بيانات النشر: | Informa UK Limited, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroids, law.invention, Standard care, Randomized controlled trial, Adrenal Cortex Hormones, law, Internal medicine, medicine, Humans, Immunology and Allergy, Adverse effect, Randomized Controlled Trials as Topic, SARS-CoV-2, business.industry, dose, Public Health, Environmental and Occupational Health, COVID-19, mortality, Respiration, Artificial, adverse events, Corticosteroid therapy, Meta-analysis, Other, business, Meta-Analysis |
| الوصف: | Background To assess the efficacy and safety of corticosteroids in COVID-19 patients compared with standard care or placebo. Methods Electronic databases were searched to identify relevant studies. The mortality, adverse events, and other data from studies were pooled for statistical analysis. Results Ten randomized clinical trials were eligible for inclusion. Corticosteroid treatment in COVID-19 patients did not significantly reduce the risk of death (RR: 0.93; CI: 0.82, 1.05) and the need for mechanical ventilation (RR: 0.82; CI: 0.62, 1.08). No mortality reduction was also observed in the subgroup of patients requiring mechanical ventilation (RR: 0.90; CI: 0.79–1.03). The use of corticosteroids increased mortality in the subgroup of patients not requiring oxygen support (RR: 1.24; CI: 1.00–1.55). The survival benefit was observed in a low dosage of corticosteroids (RR: 0.90; CI: 0.84–0.97) and dexamethasone (RR: 0.90; 95% CI: 0.79–1.04). There was no difference in the rates of adverse events (RR: 1.13; CI: 0.58, 2.20) and secondary infections (RR: 0.87; CI: 0.66, 1.15). Conclusion Corticosteroid treatment did not convincingly improve survival in severe COVID-19 patients. Low-dose dexamethasone could be considered as a drug for the treatment of COVID-19 patients. More high-quality trials are needed to further verify this conclusion. Expert Opinion: The effect of corticosteroids on patient survival highly depended on the selection of the right dosage and type and in a specific subgroup of patients. This meta-analysis, which included more RCTs, evaluated the safety and efficacy in severe COVID-19 patients and analyzed the effects of different types of corticosteroid treatments. Corticosteroid treatment did not convincingly improve survival in severe COVID-19 patients. But the low dose dexamethasone appear to have a role in the management of severe COVID-19 patients. |
| تدمد: | 1747-6356 1747-6348 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8025a1bdf973927577b1bbe3df6a3d57Test https://doi.org/10.1080/17476348.2021.1983429Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8025a1bdf973927577b1bbe3df6a3d57 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17476356 17476348 |
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