Li (2020)
Impact of corticosteroid therapy on outcomes of persons with SARS-CoV-2, SARS-CoV, or MERS-CoV infection: a systematic review and meta-analysis
https://doi.org/10.1038/s41375-020-0848-3
https://www.nature.com/articles/s41375-020-0848-3
Treatment
Treatment for coronavirus infection (Treated with corticosteroid vs. Not received)
Coronaviruses (severe/critical)
Risk ratio: 1.330 (0.730-2.420) Adjusted model

China

Review

Review

3366

Meta-analysis focus on the effects of corticosteroids on virus clearing and mortality in persons infected with SARS-CoV-2, SARS-CoV, or MERS-CoV.

We included 11 reports including 10 cohort studies and 1 randomized clinical trial involving 5249 subjects (2003–2020). Two discussed the association of corticosteroids and virus clearing and 10 explored how corticosteroids impacted mortality, hospitalization duration, use of mechanical ventilation, and a composite endpoint. Risk of bias in the randomized clinical trial was assessed according to the Jadad scale in the following domains: (1) random sequence generation; (2) allocation concealment; (3) blinding of participants and personnel; and (4) completed withdrawals and dropouts.

Total

90 Day


Coronaviruses (severe/critical)

479

Comparison of the incidence of invasive ventilation between corticosteroid and comparator.


Treatment

Treatment for coronavirus infection

Impact of corticosteroid use on use mechanical ventilation we included 3 studies

Not received

Treated with corticosteroid


Risk ratio

1.330 (0.730-2.420)

No

No

Yes

a) Pooled data and used Risk Ratios (RR) with 90 or 95% confidential Intervals (CI) for dichotomous outcomes including (1) death; and (2) the composite endpoint (death, ICU admission, or mechanical ventilation). b) Also used RR with 95% CI for dichotomous outcomes including (1) use of mechanical ventilation; and (2) corticosteroid


The correlation between corticosteroid and invasive ventilation.

Average

Yes