Ye (2020)
Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis
https://doi.org/10.1503/cmaj.200645
files/df21c4c8_Efficacy and safety of corticosteroids in COVID-19.pdf
Treatment
Treatment for COVID-19 (Treated with corticosteroid vs. Not received)
COVID-19 (death)
Hazard ratio: 0.410 (0.200-0.830) Univariate analysis

China

A systematic review and meta-analysis

Review

84

systematic reviews examining the impact of corticosteroids in COVID-19 and related severe acute respiratory illnesses.

Randomized controlled trials (RCTs) and observational studies comparing corticosteroids versus no corticosteroids in patients with COVID-19, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS). For acute respiratory distress syndrome (ARDS), influenza and communityacquired pneumonia (CAP), we updated the most recent rigorous systematic review. Our search for COVID-19, SARS and MERS identified 5120 citations. we ultimately included 1 cohort study including 84 patients with COVID-19 and ARDS, 5 cohort studies including 679 patients with COVID-19 but without ARDS, 3 studies (2 cohort studies and 1 RCT26) including 7087 patients with SARS, and 2 cohort studies including 623 patients with MERS.

0


COVID-19 (death)

0

mortality in patients with COVID-19 and ARDS


Treatment

Treatment for COVID-19

Corticosteroids in patients with COVID-19 and ARDS, based on direct evidence from observational studies of patients with COVID-19 and ARDS

Not received

Treated with corticosteroid


Hazard ratio

0.410 (0.200-0.830)

Yes

No

No

none


We are very uncertain of the effect of corticosteroids on mortality. Evidence for patients with COVID-19 and ARDS was available from a single observational study of 84 patients that suggested corticosteroids may result in a large mortality reduction compared with no corticosteroids

Average

Yes