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    v: Association of corticosteroids use and outcomes in COVID-19 patients: A systematic review and meta-analysis.
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    v: **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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      v: Knowledge Artifact Type
    user selected:
      v: false
classifier:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/citation-artifact-classifier
      l: citation-artifact-classifier
    code:
      v: D016428
    display:
      v: Journal Article
    user selected:
      v: false
artifact assessment:
  display:
    v: Classifier added by Computable Publishing LLC

type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type
      l: cited-artifact-classification-type
    code:
      v: citation-subset
    display:
      v: Citation subset
    user selected:
      v: false
classifier:
  coding:
    system:
      v: https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset
      l: citationsubset
    code:
      v: IM
    display:
      v: IM
    user selected:
      v: false

complete:
  v: true
entry:
  contributor:
    l: contributor0
    reference:
      v: #contributor0
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Tlayjeh H
  forename initials:
    v: H
  affiliation:
    display:
      v: 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:
    l: contributor1
    reference:
      v: #contributor1
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Mhish OH
  forename initials:
    v: OH
  affiliation:
    display:
      v: College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
entry:
  contributor:
    l: contributor2
    reference:
      v: #contributor2
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Enani MA
  forename initials:
    v: MA
  affiliation:
    display:
      v: Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.
entry:
  contributor:
    l: contributor3
    reference:
      v: #contributor3
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Alruwaili A
  forename initials:
    v: A
  affiliation:
    display:
      v: Clinical Pharmacy Department, Pharmacy Services Administration, King Fahad Medical City, Riyadh, Saudi Arabia.
entry:
  contributor:
    l: contributor4
    reference:
      v: #contributor4
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Tleyjeh R
  forename initials:
    v: R
  affiliation:
    display:
      v: College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
entry:
  contributor:
    l: contributor5
    reference:
      v: #contributor5
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Thalib L
  forename initials:
    v: L
  affiliation:
    display:
      v: Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
entry:
  contributor:
    l: contributor6
    reference:
      v: #contributor6
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Hassett L
  forename initials:
    v: L
  affiliation:
    display:
      v: Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
entry:
  contributor:
    l: contributor7
    reference:
      v: #contributor7
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Arabi YM
  forename initials:
    v: YM
  affiliation:
    display:
      v: 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:
    l: contributor8
    reference:
      v: #contributor8
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Kashour T
  forename initials:
    v: T
  affiliation:
    display:
      v: Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.
entry:
  contributor:
    l: contributor9
    reference:
      v: #contributor9
    type:
      v: Practitioner
      l: Practitioner
    display:
      v: Tleyjeh IM
  forename initials:
    v: IM
  affiliation:
    display:
      v: 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.