SynthesisMedicine2019
Efficacy and safety of adjunctive corticosteroids therapy for patients with severe community-acquired pneumonia: A systematic review and meta-analysis.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.
What it found
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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
21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Efficacy and safety of glucocorticoids therapy of severe community-acquired pneumonia in older adults: a systematic review and meta-analysis.BMC geriatrics · 2025Pooled it
- The effect and safety of corticosteroid treatment for severe community-acquired pneumonia: a meta-analysis of randomized controlled trials.Frontiers in medicine · 2024Pooled it
- Efficacy and safety of adjunctive corticosteroids in the treatment of severe community-acquired pneumonia: a systematic review and meta-analysis of randomized controlled trials.Critical care (London, England) · 2023Pooled 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
- Cortisol total/CRP ratio for the prediction of hospital-acquired pneumonia and initiation of corticosteroid therapy in traumatic brain-injured patients.Critical care (London, England) · 2019Trial
- Observational
- Systemic corticosteroids for severe community-acquired pneumonia: a narrative review of mechanisms and critical appraisal of recent trials in ICU.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Comparative effect of different corticosteroids in severe community-acquired pneumonia: a network meta-analysis.BMC pulmonary medicine · 2025Article
- Mortality reduction in severe community-acquired pneumonia: key findings from a large randomized controlled trial and their clinical implications.Annals of translational medicine · 2023Article
- Etiology, clinical characteristics, and risk factors associated with severe influenza-like illnesses in Mexican adults.IJID regions · 2023Article
- Relationship between steroid use and superinfections in SARS-CoV-2 patients. A systematic review and meta-analysis.Infection ecology & epidemiology · 2023Review
- Real-world corticosteroid use in severe pneumonia: a propensity-score-matched study.Critical care (London, England) · 2021Observational
- Glucocorticoids in acute pancreatitis: a propensity score matching analysis.BMC gastroenterology · 2021Article
- Comparing Several Treatments with Antibiotics for Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Iranian journal of public health · 2021Review
- Community-acquired pneumonia: similarities and differences between European and American guidelines - A narrative review.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Review
- Corticosteroids for CAP, influenza and COVID-19: when, how and benefits or harm?European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Granulocyte-targeted therapies for airway diseases.Pharmacological research · 2020Review
- Recent progress in understanding 2019 novel coronavirus (SARS-CoV-2) associated with human respiratory disease: detection, mechanisms and treatment.International journal of antimicrobial agents · 2020Article
- Antimicrobial Therapy in the Context of the Damage-Response Framework: the Prospect of Optimizing Therapy by Reducing Host Damage.Antimicrobial agents and chemotherapy · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe systemic use of corticosteroids for patients in severe community-acquired pneumonia (CAP) remains disputed in clinical practice. We undertook a systematic review and meta-analysis to assess the efficacy and safety of corticosteroids in patients with severe CAP.
methodsWe searched MEDLINE (1946 to June 2018), EMBASE (1966 to June 2018), and the Cochrane Library database for randomized controlled trials (RCTs) conducted for severe CAP. The endpoints of the study included total mortality, length of intensive care unit (ICU) stay and mechanical ventilation.
resultsNine trials which contained 914 patients were included for final meta-analysis. Of the 488 patients in the corticosteroid group, there were 37 deaths (7.58%) and 56 deaths occurred in 426 patients in the control group (13.1%). Corticosteroid therapy was associated with a lower rate of all-cause mortality compared to control (odd ratio [OR] 0.63, 95% confidence interval [CI] 0.42-0.95, P = .03). Subgroup analysis was conducted to show that the drug type modified the effect of steroids for mortality rate: prednisolone or methylprednisolone therapy (OR 0.37, 95% CI 0.19-0.72) reduced total mortality, whereas hydrocortisone use did not (OR 0.90, 95% CI 0.54-1.49). We found the length of ICU stay was significantly shorter in the steroid group compared to control (MD -2.52 days, 95% CI -4.88 to -0.15; P = .04). And there was a reduction trend in the need for mechanical ventilation in corticosteroid group (OR 0.53, 95% CI 0.28-1.02; P = .06). There was no trend towards more adverse events in the corticosteroid arm compared to control (OR 0.92, 95% CI 0.58-1.47; P = .74).
conclusionOverall, adjunctive systemic corticosteroids therapy was effective and safe for patients with severe CAP. In addition, the effects of mortality may differ according to the type of corticosteroids.
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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.