SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017
Steroid therapy and the risk of osteonecrosis in SARS patients: a dose-response meta-analysis.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 10 of them syntheses that pooled it.
What it found
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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.
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Who cites it
56 citing papers in PubMed, 10 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Population characteristics, glucocorticoid dosage, and risk factors for osteonecrosis of the femoral head in systemic lupus erythematosus: a Systematic Review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Osteonecrosis as a manifestation of Long-COVID Syndrome: a systematic review.Musculoskeletal surgery · 2025Pooled it
- The pandemic is gone but its consequences are here to stay: avascular necrosis following corticosteroids administration for severe COVID-19.Journal of orthopaedic surgery and research · 2024Pooled it
- Femoral head avascular necrosis in COVID-19 survivors: a systematic review.Rheumatology international · 2023Pooled it
- Effectiveness of corticosteroids to treat severe COVID-19: A systematic review and meta-analysis of prospective studies.International immunopharmacology · 2021Pooled it
- Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review ofTheranostics · 2021Pooled it
- Real-World Issues and Potential Solutions in Hematopoietic Cell Transplantation during the COVID-19 Pandemic: Perspectives from the Worldwide Network for Blood and Marrow Transplantation and Center for International Blood and Marrow Transplant Research Health Services and International Studies Committee.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020Guideline
- Systematic review of the registered clinical trials for coronavirus disease 2019 (COVID-19).Journal of translational medicine · 2020Pooled it
- The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis.The Journal of infection · 2020Pooled it
- Association between genetic polymorphisms and osteonecrosis in steroid treatment populations: a detailed stratified and dose-response meta-analysis.Bioscience reports · 2019Pooled it
- Prevalence of Osteonecrosis of the Femoral Head in High-Risk Male Patients with Severe COVID-19 Treated with High-Dose Corticosteroids: A Prospective Cohort Study Using Screening MRI-How Many Have Been Left Behind?Diagnostics (Basel, Switzerland) · 2026Article
- Letter to the editor regarding "osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study".Journal of orthopaedic surgery and research · 2025Article
- Phosphatidylserine-decorated delivery platform helps alleviate acute lung injury via potentiating macrophage targeting.Journal of lipid research · 2025Article
- Osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study.Journal of orthopaedic surgery and research · 2025Article
- Osteonecrosis following Steroid Therapy in COVID-19 Patients: An Outlook on the Emerging Problem.Hip & pelvis · 2025Review
- Article
- Intratracheal Administration of Stem Cell Membrane-Cloaked Naringin-Loaded Biomimetic Nanoparticles Promotes Resolution of Acute Lung Injury.Antioxidants (Basel, Switzerland) · 2024Article
- Knee osteonecrosis after SARS-CoV-2 infection: a systematic case-based review.Annals of joint · 2024Review
- Article
- Osteonecrosis Related to Steroid and Alcohol Use-An Update on Pathogenesis.Healthcare (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This meta-analysis synthesized current evidence from 10 trials to evaluate the association between steroid therapy and osteonecrosis incidence in patients with severe acute respiratory syndrome (SARS). Our results suggest that higher cumulative doses and longer treatment durations of steroids are more likely to lead to the development of osteonecrosis in SARS patients.
introductionThe link between steroid treatment and the risk of osteonecrosis in SARS patients remains unknown. The present meta-analysis aimed to examine the dose-response association between steroid therapy and osteonecrosis incidence in SARS patients. The sex differences in the development of steroid-induced osteonecrosis were also examined.
methodsWe searched PubMed, Web of Science, CNKI, and WANFANG for studies that involved steroid therapy and reported osteonecrosis data in SARS patients. Two authors independently extracted the data from the individual studies, and the rate ratio (RR) of osteonecrosis was calculated using random-effect models.
resultsTen studies with 1137 recovered SARS patients met the inclusion criteria. Close relationships between osteonecrosis incidence and both the cumulative dose and treatment duration of steroids were observed. The summary RR of osteonecrosis was 1.57 (95% confidence interval (CI) 1.30-1.89, p < 0.001) per 5.0 g increase in the cumulative dose of steroids and was 1.29 (95% CI 1.09-1.53, p = 0.003) for each 10-day increment of increase in treatment duration. The relationship was non-linear (p
conclusionsSARS patients who received higher cumulative doses and longer treatment durations of steroids were more likely to develop osteonecrosis, and there were no sex differences in this dose-dependent side effect. Our findings suggest that it is important to reduce osteonecrosis risk by modifying the cumulative dose and the treatment duration of steroids in SARS patients.
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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.