Generated Narrative: PublicationRecord 105 version: 26; Last updated: 2026-06-26 20:08:21+0000 Profile: JournalArticleCitation ArtifactPublicationStatus: Active url: https://fevir.net/resources/PublicationRecord/105 identifier: FEvIR Object Identifier/105, https://pubmed.ncbi.nlm.nih.gov/33008778 title: 33008778 Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis. status: Active author: Computable Publishing®: MEDLINE-to-FEvIR Converter: publisher: Computable Publishing LLC contact: support@computablepublishing.com description: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide. UseContexts - Code Value[x] * Citation Classification Type: fevir-platform-use (FEvIR Platform Use) Medline Base copyright: Copyright the Authors else Computable Publishing LLC. Noncommercial use permitted with CC BY-NC-SA 4.0 (https://creativecommons.org/licenses/by-nc-sa/4.0/). Commercial use permitted as agreed in Terms of Use (https://fevir.net/termsofuse). approvalDate: 2020-11-16 lastReviewDate: 2023-11-12 classification type: Citation Source classifier: MEDLINE classification type: MEDLINE Citation Owner classifier: National Library of Medicine, Index Section currentState: Medline Citation Status of Medline, PubMed PublicationStatus of ppublish statusDate activity: PubMed Pubstatus of Received period: ?? --> 2020-08-13 statusDate activity: PubMed Pubstatus of Revised period: ?? --> 2020-09-14 statusDate activity: PubMed Pubstatus of Accepted period: ?? --> 2020-09-16 statusDate activity: PubMed Pubstatus of Pubmed period: ?? --> 2020-10-04 06:00:00+0000 statusDate activity: PubMed Pubstatus of Medline period: ?? --> 2020-11-18 06:00:00+0000 statusDate activity: PubMed Pubstatus of Entrez period: ?? --> 2020-10-03 05:25:00+0000 statusDate activity: PubMed Pubstatus of PMC release period: ?? --> 2020-09-29 citedArtifact identifier: https://pubmed.ncbi.nlm.nih.gov/33008778, https://www.ncbi.nlm.nih.gov/pmc//PMC7522674, https://doi.org/10.1016/j.jiph.2020.09.008, pii/S1876-0341(20)30663-8 Titles - Type Language Text * Primary title English Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis. Abstracts - Type Text Copyright * Primary human use 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. relatesTo type: Cites classifier: Journal Article citation: Chen G., Wu D., Guo W., Cao Y., Huang D., Wang H. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620–2629. target: https://pubmed.ncbi.nlm.nih.gov/32217835/ relatesTo type: Cites classifier: Journal Article citation: Zhang W., Zhao Y., Zhang F., Wang Q., Li T., Liu Z. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): the perspectives of clinical immunologists from China. 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Am J Epidemiol. 2007;166(6):646–655. target: https://pubmed.ncbi.nlm.nih.gov/17615092/ publicationForm publishedIn type: Periodical identifier: Electronic 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 publisherLocation: England citedMedium: Internet volume: 13 issue: 11 articleDate: 2020-11 publicationDateText: 2020-Nov pageString: 1652-1663 publicationForm citedMedium: Internet without issue articleDate: 2020-09-29 webLocation classifier: Abstract url: https://pubmed.ncbi.nlm.nih.gov/33008778/ webLocation classifier: DOI Based url: https://doi.org/10.1016/j.jiph.2020.09.008 classification type: Publishing Model classifier: Print Electronic classification type: Keyword artifactAssessment: Keywords provided by NOTNLM classification type: Chemical classifier: Adrenal Cortex Hormones classification type: MeSH heading artifactAssessment: ArtifactAssessment: artifact[x] = this resource classification type: Publication type classifier: Journal Article, Meta-Analysis, Systematic Review classification type: Knowledge Artifact Type classifier: Journal Article artifactAssessment: Classifier added by Computable Publishing LLC classification type: Citation subset classifier: IM contributorship complete: true entry contributor: Tlayjeh H forenameInitials: H affiliation: Department of Intensive Care, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. entry contributor: Mhish OH forenameInitials: OH affiliation: College of Medicine, Al Faisal University, Riyadh, Saudi Arabia. entry contributor: Enani MA forenameInitials: MA affiliation: Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia. entry contributor: Alruwaili A forenameInitials: A affiliation: Clinical Pharmacy Department, Pharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia. entry contributor: Tleyjeh R forenameInitials: R affiliation: College of Medicine, Al Faisal University, Riyadh, Saudi Arabia. entry contributor: Thalib L forenameInitials: L affiliation: Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar. entry contributor: Hassett L forenameInitials: L affiliation: Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA. entry contributor: Arabi YM forenameInitials: YM affiliation: Department of Intensive Care, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. entry contributor: Kashour T forenameInitials: T affiliation: Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia. entry contributor: Tleyjeh IM forenameInitials: IM affiliation: College of Medicine, Al Faisal University, Riyadh, Saudi Arabia; Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia; Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Division of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. Electronic address: Tleyjeh.Imad@mayo.edu. 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33008778 Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.
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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.
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Department of Intensive Care, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.
Clinical Pharmacy Department, Pharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia.
Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.
College of Medicine, Al Faisal University, Riyadh, Saudi Arabia; Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia; Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Division of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. Electronic address: Tleyjeh.Imad@mayo.edu.