Additional steroid treatment for patients with influenza who are critically ill: Uncertain whether beneficial or harmful

Abstract

What is this? Corticosteroids are widely used for people with severe influenza, but there is uncertainty about their potential benefits or harms. Corticosteroids have shown evidence of benefit in sepsis and related conditions, which is most likely due to their anti-inflammatory and immunomodulatory properties. Their effects in patients with influenza might indicate their likely effects in people seriously ill with COVID-19. In this Cochrane systematic review, the authors searched for research (randomized trials, quasi-randomized trials and observational studies) which compared additional steroid treatment with no additional steroid treatment in people with influenza. They did not restrict by date, type or language of publication and did their searches in October 2018. They identified one randomized trial with two treatment groups and 29 observational studies. The randomized trial evaluated 24 participants with confirmed influenza infection but contained relatively few of the sickest patients, and none of the participants were in an intensive care unit at the time of randomization.