SMR-excluded Tlayjeh H J Infect Public Health 33008778 - Evidence Based Medicine on FHIR Implementation Guide v1.0.0-ballot3

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Citation: SMR-excluded Tlayjeh H J Infect Public Health 33008778

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A systematic review included in the Steroids SMR Project

version: 15; Last updated: 2026-06-07 15:45:00+0000

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url: https://fevir.net/resources/Citation/111

identifier: FEvIR Object Identifier/111

title: SMR-excluded Tlayjeh H J Infect Public Health 33008778

status: Active

date: 2021-09-24 12:05:20+0000

author: Brian S. Alper:

publisher: Computable Publishing LLC

contact: support@computablepublishing.com

description:

A systematic review included in the Steroids SMR Project

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Steroids SMR Project

copyright:

https://creativecommons.org/licenses/by-nc-sa/4.0/

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Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis [Journal Article]. In: Journal of infection and public health, PMID 33008778. Published September 29, 2020. Available at: https://doi.org/10.1016/j.jiph.2020.09.008.

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citedArtifact
identifier: https://pubmed.ncbi.nlm.nih.gov/33008778, pii/S1876-0341(20)30663-8, https://doi.org/10.1016/j.jiph.2020.09.008, https://www.ncbi.nlm.nih.gov/pmc//PMC7522674
Titles
- Type Text
* primary-human-use
Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.

Abstracts
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BACKGROUND: To systematically review the literature about the association between systemic corticosteroid therapy (CST) and outcomes of COVID-19 patients. METHODS: We searched Medline, Embase, EBM Reviews, Scopus, Web of Science, and preprints up to July 20, 2020. We included observational studies and randomized controlled trials (RCT) that assessed COVID-19 patients treated with CST. We pooled adjusted effect estimates of mortality and other outcomes using a random effect model, among studies at low or moderate risk for bias. We assessed the certainty of evidence for each outcome using the GRADE approach. RESULTS: Out of 1067 citations screened for eligibility, one RCT and 19 cohort studies were included (16,977 hospitalized patients). Ten studies (1 RCT and 9 cohorts) with 10,278 patients examined the effect of CST on short term mortality. The pooled adjusted RR was 0.92 (95% CI 0.69-1.22, I2 = 81.94%). This effect was observed across all stages of disease severity. Four cohort studies examined the effect of CST on composite outcome of death, ICU admission and mechanical ventilation need. The pooled adjusted RR was 0.41(0.23-0.73, I2 = 78.69%). Six cohort studies examined the effect of CST on delayed viral clearance. The pooled adjusted RR was 1.47(95% CI 1.11-1.93, I2 = 43.38%). CONCLUSION: In this systematic review, as of July 2020, heterogeneous and low certainty cumulative evidence based on observational studies and one RCT suggests that CST was not associated with reduction in short-term mortality but possibly with a delay in viral clearance in patients hospitalized with COVID-19 of different severities. However, the discordant results between the single RCT and observational studies as well as the heterogeneity observed across observational studies, call for caution in using observational data and suggests the need for more RCTs to identify the clinical and biochemical characteristics of patients' population that could benefit from CST.

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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identifier: ISSN Type/1876-035X, ISOAbbreviation/J Infect Public Health, ISSN Linking/1876-0341, Medline Title Abbreviation/J Infect Public Health, NLM Unique ID/101487384
title: Journal of infection and public health
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type: Keyword
classifier: COVID-19, Corticosteroids, Efficacy, Meta-analysis
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type: Chemical
classifier: Adrenal Cortex Hormones
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type: MeSH heading
classifier: Adrenal Cortex Hormones, Betacoronavirus, COVID-19, Coronavirus Infections, Hospitalization, Humans, Observational Studies as Topic, Pandemics, Pneumonia, Viral, Randomized Controlled Trials as Topic, SARS-CoV-2, Treatment Outcome
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