Corticosteroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials.

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.

• Authors: Yashwitha Sai Pulakurthi, John M Pederson, Kavitha Saravu, Nitin Gupta, Prasanth Balasubramanian, Shelby Kamrowski, Megan Schmidt, Charan Thej Reddy Vegivinti, Mahmoud Dibas, Natalie L Reierson, Sailaja Pisipati, Betsy Ann Joseph, Pragadeesh Thamarai Selvan, Adam A Dmytriw, Praneeth Reddy Keesari, Varsha Sriram, Spandana Chittajallu, Waleed Brinjikji, Rewanth R Katamreddy, Richa Chibbar, Amber R Davis, Manashree Malpe, Hemant K Mishra, Kevin M Kallmes, Ameer E Hassan, Kirk W Evanson
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 20 Pg. e25719 (May 21 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 34011029 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (therapeutic use)
• COVID-19 (mortality)
• Humans
• Odds Ratio
• Randomized Controlled Trials as Topic
• Respiration, Artificial (statistics & numerical data)
• SARS-CoV-2
• Treatment Outcome
• COVID-19 Drug Treatment