Generated Narrative: Citation 111 version: 15; Last updated: 2026-06-07 15:45:00+0000 ArtifactPublicationStatus: Active 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 UseContexts - Code Value[x] * UsageContextType: program (Program) Steroids SMR Project copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ Summaries - Style Text * Computable Publishing 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. RelatesTos - Type Target[x] * Derived From 33008778 Medline Base 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 - Text Copyright * 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.. 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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 classification type: Steroids SMR project use classifier: Excluded primary article classification type: Publication type classifier: Journal Article, Meta-Analysis, Systematic Review classification type: Knowledge Artifact Type classifier: Journal Article classification type: Citation subset classifier: IM classification type: Funding classifier: No funding contributorship complete: true entry entry entry entry entry entry entry entry entry entry
SMR-excluded Tlayjeh H J Infect Public Health 33008778
A systematic review included in the Steroids SMR Project
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.
Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.
**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.
Antimicrob Agents Chemother. 2020 Aug 20;64(9):
Control Clin Trials. 1986 Sep;7(3):177-88
Eur J Clin Invest. 2020 Oct;50(10):e13319
J Allergy Clin Immunol. 2020 Jul;146(1):110-118
Cochrane Database Syst Rev. 2014 Apr 29;(4):MR000034
Lancet Respir Med. 2018 Sep;6(9):691-698
EClinicalMedicine. 2020 Jun 25;24:100434
Cochrane Database Syst Rev. 2019 Jul 23;7:CD004477
Open Forum Infect Dis. 2020 Sep 12;7(10):ofaa421
Pharmacoepidemiol Drug Saf. 2018 Feb;27(2):148-160
Am J Respir Crit Care Med. 2018 Mar 15;197(6):757-767