PMID- 33013412
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220417
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 11
DP  - 2020
TI  - Efficacy and Safety of Corticosteroid Treatment in Patients With COVID-19: A 
      Systematic Review and Meta-Analysis.
PG  - 571156
LID - 10.3389/fphar.2020.571156 [doi]
LID - 571156
AB  - BACKGROUND: COVID-19 is a type of pneumonia caused by severe acute respiratory 
      syndrome coronavirus 2 (SARS-CoV-2) infection that was identified in December 
      2019. Corticosteroid therapy was empirically used for clinical treatment in the 
      early stage of the disease outbreak; however, data regarding its efficacy and 
      safety are controversial. The aim of this study was to evaluate the efficacy and 
      safety of corticosteroid therapy in patients with COVID-19. METHODS: The PubMed, 
      Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure 
      (CNKI), Wanfang, and China Science and Technology Journal (VIP) databases were 
      searched for studies. Data on clinical improvement, mortality, virus clearance 
      time, adverse events (AEs), utilization of mechanical ventilation, length of 
      intensive care unit (ICU) hospitalization, and hospital stay were extracted by 
      two authors independently. Study quality was assessed by the Newcastle Ottawa 
      Scale (cohort studies). The pooled data were meta-analyzed using a random effects 
      model, and the quality of evidence was rated using the GRADE approach. RESULTS: 
      Eleven cohort studies (corticosteroid group vs control group), two retrospective 
      cohort studies (without control group), and seven case studies were identified. A 
      total of 2840 patients were included. Compared with the control treatments, 
      corticosteroid therapy was associated with clinical recovery (RR = 1.30, 95% CI 
      [0.98, 1.72]) and a significantly shortened length of ICU hospitalization (RR = 
      -6.50; 95% CI [-7.63 to -5.37]), but it did not affect the mortality ((RR = 1.59; 
      95% CI [0.69-3.66], I(2) = 93.5%), utilization of mechanical ventilation (RR = 
      0.35; 95% CI [0.10, 1.18]), duration of symptoms (WMD = 1.69; 95% CI [-0.24 to 
      3.62]) or virus clearance time (RR = 1.01; 95% CI [-0.91 to 2.92], I(2) = 57%) in 
      COVID-19 patients. Treatment with corticosteroids in patients with COVID-19 may 
      cause mild adverse outcomes. The quality of evidence was low or very low for all 
      outcomes. CONCLUSION: The findings of our study indicate that corticosteroid 
      therapy is not highly effective, but it appears to improve prognosis and promote 
      clinical recovery in patients with severe COVID-19.
CI  - Copyright (c) 2020 Cheng, Li, Cui, Chen, Shan, Xiao, Chen, Chen and Xu.
FAU - Cheng, Wenwen
AU  - Cheng W
AD  - Department of Neurology, The First Affiliated Hospital of Jinan University, 
      Guangzhou, China.
FAU - Li, Yufeng
AU  - Li Y
AD  - Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan 
      University, Guangzhou, China.
FAU - Cui, Liyan
AU  - Cui L
AD  - Department of Rehabilitation, The First Affiliated Hospital of Jinan University, 
      Guangzhou, China.
FAU - Chen, Ying
AU  - Chen Y
AD  - Department of Ideological and Political Theory Teaching, Maoming Polytechnic, 
      Maoming, China.
FAU - Shan, Sharui
AU  - Shan S
AD  - Department of Rehabilitation, The First Affiliated Hospital of Guangdong 
      Pharmaceutical University, Guangzhou, China.
FAU - Xiao, Duan
AU  - Xiao D
AD  - Department of Rehabilitation, The First Affiliated Hospital of Jinan University, 
      Guangzhou, China.
FAU - Chen, Xiaoyun
AU  - Chen X
AD  - Department of Rehabilitation, The First Affiliated Hospital of Jinan University, 
      Guangzhou, China.
FAU - Chen, Zhuoming
AU  - Chen Z
AD  - Department of Rehabilitation, The First Affiliated Hospital of Jinan University, 
      Guangzhou, China.
FAU - Xu, Anding
AU  - Xu A
AD  - Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan 
      University, Guangzhou, China.
LA  - eng
PT  - Systematic Review
DEP - 20200909
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC7510504
OTO - NOTNLM
OT  - COVID-19
OT  - SARS-CoV-2
OT  - corticosteroid
OT  - efficacy
OT  - meta-analysis
EDAT- 2020/10/06 06:00
MHDA- 2020/10/06 06:01
PMCR- 2020/09/09
CRDT- 2020/10/05 06:14
PHST- 2020/06/10 00:00 [received]
PHST- 2020/08/17 00:00 [accepted]
PHST- 2020/10/05 06:14 [entrez]
PHST- 2020/10/06 06:00 [pubmed]
PHST- 2020/10/06 06:01 [medline]
PHST- 2020/09/09 00:00 [pmc-release]
AID - 10.3389/fphar.2020.571156 [doi]
PST - epublish
SO  - Front Pharmacol. 2020 Sep 9;11:571156. doi: 10.3389/fphar.2020.571156. 
      eCollection 2020.