dc.contributor.author | Gangopadhyay, Kalyan Kumar et al. | |
dc.date.accessioned | 2020-06-29T17:42:40Z | |
dc.date.available | 2020-06-29T17:42:40Z | |
dc.date.issued | 2020-04-22 | |
dc.identifier.uri | https://doi.org/10.1101/2020.04.17.20069773 | en_US |
dc.identifier.uri | https://hdl.handle.net/20.500.12663/1843 | |
dc.description.abstract | Objective: There are no controlled studies on the role of systemic corticosteroids (CS) in patients with coronavirus disease 2019 (COVID-19). In the absence of high-quality evidence, understandably the recommendations from various organizations are cautious. Several randomized controlled trials are underway but shall take time to conclude. We therefore undertook a meta-analysis to ascertain the role of CS in the management of critically ill patients with COVID-19. Data Sources: Electronic databases, including Pubmed, Cochrane library and Embase, were searched, using the keywords of interest and the PICO search technique, from inception to 12th April 2020. Study Selection: Studies highlighting the use of CS in coronavirus infection with severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS) and COVID-19 were selected based on pre-determined inclusion criteria. Data extraction: Data was extracted into an excel sheet and transferred to comprehensive meta-analysis software version 3, Biostat Inc., Englewood, NJ, USA, for analysis. Data synthesis: Five studies with SARS-CoV-2 infection were included in the meta-analysis. The rate ratio (RR) for mortality in patients with SARS-CoV-2 infection was 1.26 (95% CI: 0.96-1.65, I2: 74.46), indicating lack of benefit of CS therapy on mortality in critically ill patients with COVID-19. The RR for mortality on analysis of the three studies that particularly reported on patients with significant pulmonary compromise secondary to SARS-CoV-2 infection was neutral (RR: 0.91, 95% CI: 0.63-1.33, I2: 63.38). Conclusions: The use of CS in critically ill patients with COVID-19 did not improve or worsen mortality. Pending further information from controlled studies, CS can be used in critically ill patients with COVID-19 with critical illness related corticosteroid insufficiency and moderate to severe ARDS without the risk of increased mortality. | en_US |
dc.language | English | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Coronavirus | en_US |
dc.subject | Meta-Analysis | en_US |
dc.subject | Adrenal Cortex Hormones | en_US |
dc.subject | Randomized Controlled Trial | en_US |
dc.subject | Severe Acute Respiratory Syndrome | en_US |
dc.subject | Middle East Respiratory Syndrome Coronavirus | en_US |
dc.title | The role of corticosteroids in the management of critically ill patients with coronavirus disease 2019 (COVID-19): A meta-analysis | en_US |
eihealth.country | Global (WHO/OMS) | en_US |
eihealth.category | Candidate therapeutics RD | en_US |
eihealth.type | Published Article | en_US |
eihealth.maincategory | Save Lives / Salvar Vidas | en_US |
dc.relation.ispartofjournal | medRxiv | en_US |