tetano
Editor, Senior Moderator
Chest
. 2020 Oct 28;S0012-3692(20)35107-2.
doi: 10.1016/j.chest.2020.10.054. Online ahead of print.
"Impact of Corticosteroids in COVID-19 Outcomes: Systematic Review and Meta-Analysis"
Edison J Cano[SUP] 1 [/SUP], Xavier Fonseca Fuentes[SUP] 2 [/SUP], Cristina Corsini Campioli[SUP] 3 [/SUP], John C O'Horo[SUP] 4 [/SUP], Omar Abu Saleh[SUP] 3 [/SUP], Yewande Odeyemi[SUP] 2 [/SUP], Hemang Yadav[SUP] 2 [/SUP], Zelalem Temesgen[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Since its appearance in late 2019, infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have created unprecedented challenges for health systems worldwide. Multiple therapeutic options have been explored including corticosteroids (CS); preliminary results of CS in coronavirus disease 2019 (COVID-19) are encouraging, however, the role of CS is still controversial.
Research question: What is the impact of CS in mortality, ICU admission, mechanical ventilation and viral shedding in COVID-19 cases?
Study design and methods: We conducted a systematic review of literature on CS and COVID-19 in major databases (PubMed, MEDLINE, and EMBASE) of published literature until July 22, 2020, that report outcomes of interest in COVID-19 patients receiving CS with a comparative group.
Results: A total of 73 studies with 21,350 COVID-19 cases were identified. CS use was widely reported in mechanically ventilated (35.3%), ICU (51.3%) and severe COVID-19 cases (40%). CS showed mortality benefit in severelly ill COVID-19 cases (OR 0.65, 95%CI 0.51-0.83, P=0.0006), however, no beneficial or harmful effects were noted amongst high- or low-dose CS regimens. Emerging evidence shows that low-dose CS 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- and low-dose CS regimens.
Interpretation: Our results show evidence of mortality benefit in severely-ill COVID-19 treated with CS. CS are widely used in COVID-19 cases worldwide and a rapidly developing global pandemic warrants further high-quality clinical trials to define the most beneficial timing and dosing for CS.
Keywords: COVID-19; Coronavirus; Corticosteroids; Outcomes.
. 2020 Oct 28;S0012-3692(20)35107-2.
doi: 10.1016/j.chest.2020.10.054. Online ahead of print.
"Impact of Corticosteroids in COVID-19 Outcomes: Systematic Review and Meta-Analysis"
Edison J Cano[SUP] 1 [/SUP], Xavier Fonseca Fuentes[SUP] 2 [/SUP], Cristina Corsini Campioli[SUP] 3 [/SUP], John C O'Horo[SUP] 4 [/SUP], Omar Abu Saleh[SUP] 3 [/SUP], Yewande Odeyemi[SUP] 2 [/SUP], Hemang Yadav[SUP] 2 [/SUP], Zelalem Temesgen[SUP] 3 [/SUP]
Affiliations
- PMID: 33129791
- DOI: 10.1016/j.chest.2020.10.054
Abstract
Background: Since its appearance in late 2019, infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have created unprecedented challenges for health systems worldwide. Multiple therapeutic options have been explored including corticosteroids (CS); preliminary results of CS in coronavirus disease 2019 (COVID-19) are encouraging, however, the role of CS is still controversial.
Research question: What is the impact of CS in mortality, ICU admission, mechanical ventilation and viral shedding in COVID-19 cases?
Study design and methods: We conducted a systematic review of literature on CS and COVID-19 in major databases (PubMed, MEDLINE, and EMBASE) of published literature until July 22, 2020, that report outcomes of interest in COVID-19 patients receiving CS with a comparative group.
Results: A total of 73 studies with 21,350 COVID-19 cases were identified. CS use was widely reported in mechanically ventilated (35.3%), ICU (51.3%) and severe COVID-19 cases (40%). CS showed mortality benefit in severelly ill COVID-19 cases (OR 0.65, 95%CI 0.51-0.83, P=0.0006), however, no beneficial or harmful effects were noted amongst high- or low-dose CS regimens. Emerging evidence shows that low-dose CS 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- and low-dose CS regimens.
Interpretation: Our results show evidence of mortality benefit in severely-ill COVID-19 treated with CS. CS are widely used in COVID-19 cases worldwide and a rapidly developing global pandemic warrants further high-quality clinical trials to define the most beneficial timing and dosing for CS.
Keywords: COVID-19; Coronavirus; Corticosteroids; Outcomes.