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10.1016/j.chest.2020.10.054

http://scihub22266oqcxt.onion/10.1016/j.chest.2020.10.054
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suck abstract from ncbi


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pmid33129791      Chest 2021 ; 159 (3): 1019-1040
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  • Impact of Corticosteroids in Coronavirus Disease 2019 Outcomes: Systematic Review and Meta-analysis #MMPMID33129791
  • Cano EJ; Fonseca Fuentes X; Corsini Campioli C; O'Horo JC; Abu Saleh O; Odeyemi Y; Yadav H; Temesgen Z
  • Chest 2021[Mar]; 159 (3): 1019-1040 PMID33129791show ga
  • BACKGROUND: Since its appearance in late 2019, infections caused by severe acute respiratory syndrome coronavirus 2 have created unprecedented challenges for health systems worldwide. Multiple therapeutic options have been explored, including corticosteroids. Preliminary results of corticosteroids in coronavirus disease 2019 (COVID-19) are encouraging; however, the role of corticosteroids remains controversial. RESEARCH QUESTION: What is the impact of corticosteroids in mortality, ICU admission, mechanical ventilation, and viral shedding in COVID-19 patients? STUDY DESIGN AND METHODS: We conducted a systematic review of literature on corticosteroids and COVID-19 in major databases (PubMed, MEDLINE, and EMBASE) of published literature through July 22, 2020, that report outcomes of interest in COVID-19 patients receiving corticosteroids with a comparative group. RESULTS: A total of 73 studies with 21,350 COVID-19 patients were identified. Corticosteroid use was reported widely in mechanically ventilated patients (35.3%), ICU patients (51.3%), and severe COVID-19 patients (40%). Corticosteroids showed mortality benefit in severelly ill COVID-19 patients (OR, 0.65; 95% CI, 0.51-0.83; P = .0006); however, no beneficial or harmful effects were noted among high-dose or low-dose corticosteroid regimens. Emerging evidence shows that low-dose corticosteroids do not have a significant impact in the duration of SARS-CoV-2 viral shedding. The analysis was limited by highly heterogeneous literature for high-dose and low-dose corticosteroids regimens. INTERPRETATION: Our results showed evidence of mortality benefit in severely ill COVID-19 patients treated with corticosteroids. Corticosteroids are used widely in COVID-19 patients worldwide, and a rapidly developing global pandemic warrants further high-quality clinical trials to define the most beneficial timing and dosing for corticosteroids.
  • |*COVID-19 Drug Treatment[MESH]
  • |*COVID-19/epidemiology[MESH]
  • |Dose-Response Relationship, Drug[MESH]
  • |Glucocorticoids/*pharmacology[MESH]
  • |Humans[MESH]
  • |Mortality[MESH]
  • |SARS-CoV-2/*drug effects/physiology[MESH]


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