SynthesisJournal of cardiothoracic and vascular anesthesia2021
Corticosteroids for Patients With Coronavirus Disease 2019 (COVID-19) With Different Disease Severity: A Meta-Analysis of Randomized Clinical Trials.
Synthesis in Journal of cardiothoracic and vascular anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 8 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
55 citing papers in PubMed, 8 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Higher- versus Lower-Dose Corticosteroids for Severe to Critical COVID-19: A Systematic Review and Dose-Response Meta-analysis.Annals of the American Thoracic Society · 2023Pooled it
- Systemic corticosteroids for the treatment of COVID-19: Equity-related analyses and update on evidence.The Cochrane database of systematic reviews · 2022Pooled it
- Systemic administration of glucocorticoids, cardiovascular complications and mortality in patients hospitalised with COVID-19, SARS, MERS or influenza: A systematic review and meta-analysis of randomised trials.Pharmacological research · 2022Pooled it
- Use of steroids in COVID-19 patients: A meta-analysis.European journal of pharmacology · 2022Pooled it
- Effects of different corticosteroid therapy on severe COVID-19 patients: a meta-analysis of randomized controlled trials.Expert review of respiratory medicine · 2022Pooled it
- Systemic corticosteroids for the treatment of COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- Anakinra for patients with COVID-19: a meta-analysis of non-randomized cohort studies.European journal of internal medicine · 2021Pooled it
- Efficacy and safety of systematic corticosteroids among severe COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials.Signal transduction and targeted therapy · 2021Pooled it
- Early C-reactive protein reduction predicts survival in COVID-19 severe pneumonia treated with glucocorticoids.BMC pulmonary medicine · 2025Trial
- Methylprednisolone pulse therapy compared with intravenous dexamethasone for severe COVID-19 patients: a randomized clinical trial.Virology journal · 2025Trial
- Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial.The Lancet. Respiratory medicine · 2022Trial
- Glucocorticoids suppress early lung inflammation and impair control of SARS-CoV-2 in non-human primates.PloS one · 2026Article
- Lower Mortality Risk Associated With Remdesivir + Dexamethasone Versus Dexamethasone Alone for the Treatment of Patients Hospitalized for COVID-19.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Time‑dependent ROC curve analysis to determine the predictive capacity of seven clinical scales for mortality in patients with COVID‑19: Study of a hospital cohort with very high mortality.Biomedical reports · 2024Article
- Article
- Remdesivir Reduced Mortality in Immunocompromised Patients Hospitalized for COVID-19 Across Variant Waves: Findings From Routine Clinical Practice.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Cancer management during the COVID-19 world pandemic.Cancer immunology, immunotherapy : CII · 2023Review
- Therapeutic considerations for prevention and treatment of thrombotic events in COVID-19.Thrombosis update · 2023Review
- A differential therapeutic consideration for use of corticosteroids according to established COVID-19 clinical phenotypes in critically ill patients.Medicina intensiva · 2023Article
- Relationship between steroid use and superinfections in SARS-CoV-2 patients. A systematic review and meta-analysis.Infection ecology & epidemiology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEfficacy and safety of corticosteroids in patients with 2019-nCoV (novel coronavirus 2019) infection still are debated. Because large randomized clinical trials (RCTs) and a well-conducted meta-analysis on the use of corticosteroids, focused on patients with coronavirus disease (COVID-19) in intensive care units, recently were published, a meta-analysis of RCTs on corticosteroids therapy in patients with different disease severity was performed to evaluate the effect on survival.
designA meta-analyses of RCTs was performed.
settingPatients admitted to hospital.
participantsPatients with coronavirus disease.
interventionsAdministration of corticosteroids. MEASUREMENTS AND MAIN
resultsA search was performed for RCTs of adult patients with acute hypoxemic failure related to 2019-nCoV infection who received corticosteroids versus any comparator. The primary endpoint was mortality rate. Five RCTs involving 7,692 patients were included. Overall mortality of patients treated with corticosteroids was slightly but significantly lower than mortality of controls (26% v 28%, relative risk {RR} = 0.89 [95% confidence interval {CI} 0.82-0.96], p = 0.003). The same beneficial effect was found in the subgroup of patients requiring mechanical ventilation (RR = 0.85 [95% CI 0.72-1.00], p = 0.05 number needed to treat {NNT} = 19). Remarkably, corticosteroids increased mortality in the subgroup of patients not requiring oxygen (17% v 13%, RR = 1.23 [95% CI 1.00-1.62], p = 0.05 number needed to harm {NNH} = 29). Tests for comparison between mechanically ventilated subgroups and those not requiring oxygen confirmed that treatment with corticosteroids had a statistically significant different effect on survival. Patients treated with corticosteroids had a significantly lower risk of need for mechanical ventilation.
conclusionsCorticosteroids may be considered in severe critically ill patients with COVID-19 but must be discouraged in patients not requiring oxygen therapy. Urgently, further trials are warranted before implementing this treatment worldwide.
Indexed as
Identifiers
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.