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

Autor:	Pulakurthi YS; Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India., Pederson JM; Nested Knowledge, St. Paul, MN., Saravu K; Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India., Gupta N; Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India., Balasubramanian P; Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY., Kamrowski S; Nested Knowledge, St. Paul, MN., Schmidt M; Nested Knowledge, St. Paul, MN., Vegivinti CTR; Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India., Dibas M; Sulaiman Al Rajhi University, College of Medicine, Saudi Arabia., Reierson NL; Nested Knowledge, St. Paul, MN., Pisipati S; Department of Gastroenterology, Mayo Clinic, Scottsdale, AZ., Joseph BA; Nested Knowledge, St. Paul, MN., Selvan PT; Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India., Dmytriw AA; Neuroradiology & Neurointervention Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Keesari PR; Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India., Sriram V; Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India., Chittajallu S; Rangaraya Medical College, Kakinada, Andhra Pradesh, India., Brinjikji W; Department of Radiology, Mayo Clinic, Rochester, MN., Katamreddy RR; Department of General Surgery, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India., Chibbar R; Department of Medicine, Lakeridge Health, Oshawa, ON, Canada., Davis AR; Superior Medical Experts, St. Paul., Malpe M; Superior Medical Experts, St. Paul., Mishra HK; University of Minnesota, Twin Cities, MN., Kallmes KM; Nested Knowledge, St. Paul, MN., Hassan AE; Department of Neuroradiology, Valley Baptist Medical Center-Harlingen, Texas., Evanson KW; Superior Medical Experts, St. Paul.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2021 May 21; Vol. 100 (20), pp. e25719.
DOI:	10.1097/MD.0000000000025719
Abstrakt:	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. Competing Interests: The authors have no funding and conflicts of interests to disclose. (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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