SynthesisCritical care (London, England)2015
Do corticosteroids reduce the mortality of influenza A (H1N1) infection? A meta-analysis.
Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 7 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Analysis of risk factors of fungal superinfections in viral pneumonia patients: A systematic review and meta-analysis.Immunity, inflammation and disease · 2023Pooled it
- Preparing for pandemics: a systematic review of pandemic influenza clinical management guidelines.BMC medicine · 2022Pooled it
- Pooled it
- Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- The effect of corticosteroids on mortality of patients with influenza pneumonia: a systematic review and meta-analysis.Critical care (London, England) · 2019Pooled it
- Corticosteroids as adjunctive therapy in the treatment of influenza.The Cochrane database of systematic reviews · 2019Pooled it
- Adjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-Analysis.PloS one · 2015Pooled it
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- [Acute respiratory distress syndrome : Pathophysiology, definition and treatment strategies].Die Anaesthesiologie · 2025Review
- Mendelian randomization analysis reveals causal relationship between allergic diseases and influenza.The World Allergy Organization journal · 2025Article
- The global burden of swine influenza and its mitigation.Open veterinary journal · 2025Review
- [Acute respiratory distress syndrome : Pathophysiology, definition and treatment strategies].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Outcomes of corticosteroid therapy in patients with viral community-acquired pneumonia.Pneumonia (Nathan Qld.) · 2024Article
- Managing the Next Wave of Influenza and/or SARS-CoV-2 in the ICU-Practical Recommendations from an Expert Group for CAPA/IAPA Patients.Journal of fungi (Basel, Switzerland) · 2023Article
- Glucocorticoid Therapy in COVID-19.Seminars in respiratory and critical care medicine · 2023Review
- Glucocorticoid therapy in respiratory illness: bench to bedside.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2022Review
- In vitro anti-influenza assessment of anionic compounds ascorbate, acetate and citrate.Virology journal · 2022Article
- Critical Influenza and COVID-19-A Comparative Nationwide Case-Control Study.Critical care explorations · 2022Article
- Mechanistic Basis of Super-Infection: Influenza-Associated Invasive Pulmonary Aspergillosis.Journal of fungi (Basel, Switzerland) · 2022Review
- Dexamethasone for Severe COVID-19: How Does It Work at Cellular and Molecular Levels?International journal of molecular sciences · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCorticosteroids are used empirically in influenza A (H1N1) treatment despite lack of clear evidence for effective treatment. This study aims to assess the efficacy of corticosteroids treatment for H1N1 infection.
methodsSystematic review and meta-analysis were used to estimate the efficacy of corticosteroids for the prevention of mortality in H1N1 infection. Databases searched included MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Clinical Trials and so on, and bibliographies of retrieved articles, from April 2009 to October 2014. We included both cohort studies and case-control studies reported in English or Chinese that compared treatment effects between corticosteroids and non-corticosteroids therapy in inpatients with H1N1 virus infection. Cohort studies employed mortality as outcome, and case-control studies employed deaths as cases and survivors as controls; both were assessed in this meta-analysis.
resultsIn total twenty-three eligible studies were included. Both cohort studies (nine studies, n = 1,405) and case-control studies (14 studies, n = 4,700) showed a similar trend toward increased mortality (cohort studies relative risk was 1.85 with 95% confidence interval (CI) 1.46 to 2.33; case-control studies odds ratio was 4.22 with 95% CI 3.10 to 5.76). The results from both subgroup analyses and sensitive analyses were consistent with each other, showing that steroid treatment is associated with mortality. However, considering the fact that corticosteroids were tend to be used in sickest case-patients and heterogeneity was observed between studies, we cannot make a solid conclusion.
conclusionsAvailable evidence did not support the use of corticosteroids as standard care for patients with severe influenza. We conclude that further research is required.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.