Evidence map›Paper›PMID 33129791›Full record

SynthesisChest2021

Impact of Corticosteroids in Coronavirus Disease 2019 Outcomes: Systematic Review and Meta-analysis.

Edison J Cano, Xavier Fonseca Fuentes, Cristina Corsini Campioli, John C O'Horo, Omar Abu Saleh, Yewande Odeyemi, Hemang Yadav, Zelalem Temesgen

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 9 pooled it
4.2field-weighted citation impact, top 4% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 9 syntheses or guidelines pooled it, 182 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Use of steroids in COVID-19 patients: A meta-analysis.European journal of pharmacology · 2022
    Pooled it
  7. Pooled it
  8. Pooled it
  9. Guideline
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Article
  15. Observational
  16. Article
  17. Article
  18. Review
  19. Review
  20. Article

54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Edison J CanoDivision of Infectious Disease, Mayo Clinic, Rochester, MN. Electronic address: canocevallos.edison@mayo.edu.
Xavier Fonseca FuentesDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Cristina Corsini CampioliDivision of Infectious Disease, Mayo Clinic, Rochester, MN.
John C O'HoroDivision of Infectious Disease, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Omar Abu SalehDivision of Infectious Disease, Mayo Clinic, Rochester, MN.
Yewande OdeyemiDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Hemang YadavDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Zelalem TemesgenDivision of Infectious Disease, Mayo Clinic, Rochester, MN.
Mayo Clinic in Arizona · USMayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince its appearance in late 2019, infections caused by severe acute respiratory syndrome coronavirus 2 have created unprecedented challenges for health systems worldwide. Multiple therapeutic options have been explored, including corticosteroids. Preliminary results of corticosteroids in coronavirus disease 2019 (COVID-19) are encouraging; however, the role of corticosteroids remains controversial. RESEARCH QUESTION: What is the impact of corticosteroids in mortality, ICU admission, mechanical ventilation, and viral shedding in COVID-19 patients? STUDY DESIGN AND

methodsWe conducted a systematic review of literature on corticosteroids and COVID-19 in major databases (PubMed, MEDLINE, and EMBASE) of published literature through July 22, 2020, that report outcomes of interest in COVID-19 patients receiving corticosteroids with a comparative group.

resultsA total of 73 studies with 21,350 COVID-19 patients were identified. Corticosteroid use was reported widely in mechanically ventilated patients (35.3%), ICU patients (51.3%), and severe COVID-19 patients (40%). Corticosteroids showed mortality benefit in severelly ill COVID-19 patients (OR, 0.65; 95% CI, 0.51-0.83; P = .0006); however, no beneficial or harmful effects were noted among high-dose or low-dose corticosteroid regimens. Emerging evidence shows that low-dose corticosteroids do not have a significant impact in the duration of SARS-CoV-2 viral shedding. The analysis was limited by highly heterogeneous literature for high-dose and low-dose corticosteroids regimens.

interpretationOur results showed evidence of mortality benefit in severely ill COVID-19 patients treated with corticosteroids. Corticosteroids are used widely in COVID-19 patients worldwide, and a rapidly developing global pandemic warrants further high-quality clinical trials to define the most beneficial timing and dosing for corticosteroids.

Indexed as

COVID-19COVID-19 Drug TreatmentDose-Response Relationship, DrugGlucocorticoidsHumansMortalitySARS-CoV-2Virus SheddingGlucocorticoidscoronavirus: corticosteroidsCOVID-19outcomes

Identifiers

PMID33129791
PMCPMC7598533
OpenAlexW3110379274

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.