Efficacy and safety of corticosteroid regimens for the treatment of hospitalized COVID-19 patients: a meta-analysis

被引:8
作者
Zhou, Fangwen [1 ]
Deng, Jiawen [1 ]
Heybati, Kiyan [2 ]
Zuo, Qi Kang [3 ,4 ]
Ali, Saif [1 ]
Hou, Wenteng [1 ]
Wong, Chi Yi [1 ]
Ramaraju, Harikrishnaa Ba [1 ]
Chang, Oswin [1 ]
Dhivagaran, Thanansayan [1 ,5 ]
Silver, Zachary [6 ]
机构
[1] McMaster Univ, Fac Hlth Sci, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
[2] Mayo Clin, Alix Sch Med, 200 First St SW, Rochester, MN 55905 USA
[3] Rutgers New Jersey Med Sch, Dept Anesthesiol, 185 S Orange Ave, Newark, NJ 07103 USA
[4] McGill Univ, Fac Sci, 845 Sherbrooke St W, Montreal, PQ H3A 0G5, Canada
[5] McMaster Univ, Integrated Biomed Engn & Hlth Sci Program iBioMed, 1280 Main St W, Hamilton, ON L8S 4L8, Canada
[6] Carleton Univ, Fac Sci, 1125 Colonel By Dr, Ottawa, ON K1S 5B6, Canada
关键词
corticosteroids; COVID-19; length of stay; mechanical ventilation; mortality; SARS-CoV-2; CORONAVIRUS DISEASE 2019; CRITICALLY-ILL PATIENTS; MECHANICAL VENTILATION; INFECTION; THERAPY; METHYLPREDNISOLONE; GLUCOCORTICOIDS; MULTICENTER; SARS-COV-2; GUIDELINES;
D O I
10.2217/fvl-2021-0244
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Aim: To evaluate the efficacy and safety of corticosteroids for treating hospitalized COVID-19 patients. Materials & methods: Efficacy outcomes included time to negative SARS-CoV-2 tests, length of stay, duration and incidence of intensive unit care stay, incidence of mortality and duration and incidence of mechanical ventilation. Safety outcomes included the incidence of adverse events and severe adverse events, incidence of hyperglycemia and incidence of nosocomial infections. Results: Ninety-five randomized controlled trials (RCTs) and observational studies (n = 42,205) were included. Corticosteroids were associated with increased length of stay (based on RCT only), increased time to negative tests, decreased length of mechanical ventilation and increased odds of hyperglycemia. Conclusion: Corticosteroids should be considered in patients requiring mechanical ventilation, and glycemic monitoring may be needed when administering corticosteroids.
引用
收藏
页码:463 / 489
页数:27
相关论文
共 193 条
  • [61] He R., 2021, ACTA U MED ANHUI, V56, P991
  • [62] Late Breaking Abstract - Corticosteroids reduce mortality and prevent ICU admission in Covid-19 pneumonia - results from a rapid clinical review of 191 patients
    Heaton, Joanne
    Malhotra, Puneet
    Stockton, Paul
    Rossiter, Laurie
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2020, 56
  • [63] Hicks, 2020, LIB GUIDES TU GOARN
  • [64] Higgins JP, 2008, Cochrane handbook for systematic reviews of interventions: Cochrane book series, VFirst, DOI [DOI 10.1002/9780470712184, 10.1002/9780470712184]
  • [65] Measuring inconsistency in meta-analyses
    Higgins, JPT
    Thompson, SG
    Deeks, JJ
    Altman, DG
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2003, 327 (7414): : 557 - 560
  • [66] Impact of corticosteroids in hospitalised COVID-19 patients
    Ho, Kam Sing
    Narasimhan, Bharat
    Difabrizio, Larry
    Rogers, Linda
    Bose, Sonali
    Li, Li
    Chen, Roger
    Sheehan, Jacqueline
    El-Halabi, Maan Ajwad
    Sarosky, Kimberly
    Wang, Zichen
    Eisenberg, Elliot
    Powell, Charles
    Steiger, David
    [J]. BMJ OPEN RESPIRATORY RESEARCH, 2021, 8 (01)
  • [67] Dexamethasone use and mortality in hospitalized patients with coronavirus disease 2019: A multicentre retrospective observational study
    Hoertel, Nicolas
    Sanchez-Rico, Marina
    Vernet, Raphael
    Beeker, Nathanael
    Neuraz, Antoine
    Alvarado, Jesus M.
    Daniel, Christel
    Paris, Nicolas
    Gramfort, Alexandre
    Lemaitre, Guillaume
    Salamanca, Elisa
    Bernaux, Melodie
    Bellamine, Ali
    Burgun, Anita
    Limosin, Frederic
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2021, 87 (10) : 3766 - 3775
  • [68] CORTICOSTEROID TREATMENT IN PATIENTS WITH SEVERE COVID-19 PNEUMONIA
    Hong, Gloria
    Patel, Manishkumar
    Tusha, Jurgena
    Giri, Padmini
    Al-Janabi, Laith
    Adusumilli, Radha Kishan
    Schmidt, Bernadette
    Kumar, Sarwan
    [J]. CHEST, 2020, 158 (04) : 599A - 599A
  • [69] Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19
    Horby, Peter
    Mafham, Marion
    Linsell, Louise
    Bell, Jennifer L.
    Staplin, Natalie
    Emberson, Jonathan R.
    Wiselka, Martin
    Ustianowski, Andrew
    Elmahi, Einas
    Prudon, Benjamin
    Whitehouse, Tony
    Felton, Timothy
    Williams, John
    Faccenda, Jakki
    Underwood, Jonathan
    Baillie, J. Kenneth
    Chappell, Lucy C.
    Faust, Saul N.
    Jaki, Thomas
    Jeffery, Katie
    Lim, Wei Shen
    Montgomery, Alan
    Rowan, Kathryn
    Tarning, Joel
    Watson, James A.
    White, Nicholas J.
    Juszczak, Edmund
    Haynes, Richard
    Landray, Martin J.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (21) : 2030 - 2040
  • [70] Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
    Horby, Peter W.
    Landray, Martin J.
    Mafham, Marion
    Bell, Jennifer L.
    Linsell, Louise
    Staplin, Natalie
    Emberson, Jonathan R.
    Palfreeman, Adrian
    Raw, Jason
    Elmahi, Einas
    Prudon, Benjamin
    Green, Christopher
    Carley, Simon
    Chadwick, David
    Davies, Matthew
    Wise, Matthew P.
    Baillie, J. Kenneth
    Chappell, Lucy C.
    Faust, Saul N.
    Jaki, Thomas
    Jeffery, Katie
    Lim, Wei Shen
    Montgomery, Alan
    Rowan, Kathryn
    Juszczak, Edmund
    Haynes, Richard
    [J]. LANCET, 2020, 396 (10259) : 1345 - 1352