Article type
Year
Abstract
Background:Glucocorticoid is widely used in the treatment of various pulmonary inflammatory diseases, but it is also often accompanied by significant adverse reactions. Published guidelines point out that low dose and short duration systemic glucocorticoids may be considered for patients with rapid disease progression in adults or children with COVID-19. However, there is still no effective evidence and its possible harm, which needs to be paid enough attention.
Objectives:The purpose of our study is to systematically review the effectiveness and safety of glucocorticoid in COVID-19 patients.
Methods:We comprehensively searched electronic databases (from 2003), completed predefined hand searching, and contacted experts. Two reviewers applied inclusion criteria. We included randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness and safety of glucocorticoid in children and adults COVID-19, SARS and MERS patients, and combine the same outcome indicators for meta-analysis and systematic review. Our search now retrieved 23 studies, including one randomized controlled trial and 22 cohort studies, with a total of 13,815 patients.
Results:Our search retrieved 23 studies, including one randomized controlled trial and 22 cohort studies, with a total of 13,815 patients. Our meta-analysis showed that in adults with COVID-19, the use of systemic glucocorticoid did not reduce mortality (RR=2.00, 95%CI: 0.69 to 5.75, I2=90.9%) and the duration of lung inflammation (WMD=-1 day, 95%CI: -2.91 to 0.91), while a significant reduce shown in the duration of fever (WMD=-3.23 days, 95%CI: -3.56 to -2.90). Using glucocorticoids did not reduce the mortality (RR=1.52, 95%CI: 0.89 to 2.60, I2=84.6%), duration of fever (WMD=0.82 days, 95%CI: -2.88 to 4.52, I2=97.9%) and duration of lung inflammation absorption (WMD=0.95 days, 95%CI: -7.57 to 9.48, I2=94.6%) in SARS patients. And the use of systemic glucocorticoid significantly prolonged hospital stay of COVID-19, SARS and MERS patients.
Conclusions:Glucocorticoid therapy significantly reduced the duration of fever, but did not reduce the mortality, hospital stay and lung inflammation absorption in patients with whether in COVID-19 patients. Long-term use of high-dose glucocorticoids increased the risk of adverse reactions such as infections, so routine use of systemic glucocorticoids for patients with COVID -19 population is not recommend.
Patient or healthcare consumer involvement:None.
Objectives:The purpose of our study is to systematically review the effectiveness and safety of glucocorticoid in COVID-19 patients.
Methods:We comprehensively searched electronic databases (from 2003), completed predefined hand searching, and contacted experts. Two reviewers applied inclusion criteria. We included randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness and safety of glucocorticoid in children and adults COVID-19, SARS and MERS patients, and combine the same outcome indicators for meta-analysis and systematic review. Our search now retrieved 23 studies, including one randomized controlled trial and 22 cohort studies, with a total of 13,815 patients.
Results:Our search retrieved 23 studies, including one randomized controlled trial and 22 cohort studies, with a total of 13,815 patients. Our meta-analysis showed that in adults with COVID-19, the use of systemic glucocorticoid did not reduce mortality (RR=2.00, 95%CI: 0.69 to 5.75, I2=90.9%) and the duration of lung inflammation (WMD=-1 day, 95%CI: -2.91 to 0.91), while a significant reduce shown in the duration of fever (WMD=-3.23 days, 95%CI: -3.56 to -2.90). Using glucocorticoids did not reduce the mortality (RR=1.52, 95%CI: 0.89 to 2.60, I2=84.6%), duration of fever (WMD=0.82 days, 95%CI: -2.88 to 4.52, I2=97.9%) and duration of lung inflammation absorption (WMD=0.95 days, 95%CI: -7.57 to 9.48, I2=94.6%) in SARS patients. And the use of systemic glucocorticoid significantly prolonged hospital stay of COVID-19, SARS and MERS patients.
Conclusions:Glucocorticoid therapy significantly reduced the duration of fever, but did not reduce the mortality, hospital stay and lung inflammation absorption in patients with whether in COVID-19 patients. Long-term use of high-dose glucocorticoids increased the risk of adverse reactions such as infections, so routine use of systemic glucocorticoids for patients with COVID -19 population is not recommend.
Patient or healthcare consumer involvement:None.