Comparison of Efficacy and Safety of Low-Dose Versus High-Dose Dexamethasone in Hospitalized COVID-19 Patients: A Meta-Analysis.

Autor:	Waheed MD; Internal Medicine, Foundation University Medical College, Islamabad, PAK., Shaikh A; Medicine, Foundation University Medical College, Islamabad, PAK., Sidhu SM; Medicine, Jinnah Medical and Dental College, Karachi, PAK., Ahmad S; Internal Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK., Sikander T; Internal Medicine, Jinnah Medical and Dental College, Karachi, PAK., Chaudhry AR; Emergency Department, Bahawal Victoria Hospital, Bahawalpur, PAK., Iftikhar I; Internal Medicine, Quaid-e-Azam Medical College, Bahawalpur, PAK., Shaik TA; Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jan 17; Vol. 15 (1), pp. e33884. Date of Electronic Publication: 2023 Jan 17 (Print Publication: 2023).
DOI:	10.7759/cureus.33884
Abstrakt:	The aim of this study is to compare the efficacy and safety of low-dose and high-dose dexamethasone in hospitalized coronavirus disease 2019 (COVID-19) patients. The current meta-analysis was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was carried out using PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Embase. Outcomes assessed in the current meta-analysis included 28-day mortality, intensive care unit (ICU) admission, mechanical ventilation, length of ICU admission (days), and length of hospital stay (days). For safety, we compared hypoglycemia and the incidence of infection between the high-dose dexamethasone group and the low-dose dexamethasone group. A total of four studies fulfilled the inclusion criteria and were included in this meta-analysis. No significant difference was found between the two groups in terms of ICU admission (risk ratio (RR): 0.72, 95% confidence interval (CI): 0.41-1.28, p-value: 0.27), length of stay in ICU in days (mean difference (MD): -0.05, 95%CI: -3.96-3.87, p-value: 0.98, I-square: 94%), length of hospital stay in days (MD: -0.94, 95%CI: -1.94-0.06, p-value: 0.07), need of mechanical ventilation (RR: 0.72, 95%CI: 0.36-1.48, p-value: 0.38), and 28-day mortality (RR: 0.90, 95% CI: 0.50-1.64, p-value: 0.74). The current study showed that higher doses of dexamethasone failed to enhance efficacy compared to low-dose dexamethasone. Thus, based on the findings of this meta-analysis, low-dose dexamethasone can be recommended for these patients. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Waheed et al.)
Databáze:	MEDLINE
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