Observational studyCritical care (London, England)2021
Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19: a cohort study.
Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04836780 (DEXamethasone EARLY Administration in Hospitalized Patients With Covid-19 Pneumonia and High Risk of Developing Acute Respiratory Distress Syndrome), which is not on this map. Cited by 44 papers, 4 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.
DEXamethasone EARLY Administration in Hospitalized Patients With Covid-19 Pneumonia and High Risk of Developing Acute Respiratory Distress Syndrome
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis.Journal of cardiothoracic and vascular anesthesia · 2022Pooled it
- Updated Living Systematic Review and Meta-analysis of Controlled Trials of Mesenchymal Stromal Cells to Treat COVID-19: A Framework for Accelerated Synthesis of Trial Evidence for Rapid Approval-FASTER Approval.Stem cells translational medicine · 2022Pooled it
- Steroid therapy and antiviral treatment in SARS-CoV-2 pneumonia: clinical contexts and indications.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Pooled it
- Effectiveness of corticosteroids to treat severe COVID-19: A systematic review and meta-analysis of prospective studies.International immunopharmacology · 2021Pooled it
- A comparative study between methylprednisolone versus dexamethasone as an initial anti-inflammatory treatment of moderate COVID-19 pneumonia: an open-label randomized controlled trial.BMC pulmonary medicine · 2024Trial
- Plasma matrix metalloproteinase-3 predicts mortality in acute respiratory distress syndrome: a biomarker analysis of a randomized controlled trial.Respiratory research · 2023Trial
- Sex-based differences in mortality among a large cohort of hospitalized patients with RT-PCR-confirmed SARS-CoV-2 infection at five different pandemic waves in Northern Iran.Scientific reports · 2025Article
- Correlation between the severity of COVID-19 infection and the presence of oropharyngeal candidiasis: a cross-sectional study in Al-Diwaniyah Hospital, Iraq.The Pan African medical journal · 2025Article
- Article
- CT-based Assessment at 6-Month Follow-up of COVID-19 Pneumonia patients in China.Scientific reports · 2024Article
- Evaluation of High-doseCurrent drug safety · 2024Observational
- Publisher Correction: Early corticosteroids are associated with lower mortality in critically ill patients with COVID‑19: a cohort study.Critical care (London, England) · 2023Article
- Acute Necrotizing Encephalopathy in Adult Patients With COVID-19: A Systematic Review of Case Reports and Case Series.Journal of clinical neurology (Seoul, Korea) · 2023Article
- Methylprednisolone pulse therapy for critically ill patients with COVID-19: a cohort study.Acute and critical care · 2023Article
- Clinical relevance of timing of assessment of ICU mortality in patients with moderate-to-severe Acute Respiratory Distress Syndrome.Scientific reports · 2023Article
- Effect of Methylprednisolone on Mortality and Clinical Courses in Patients with Severe COVID-19: A Propensity Score Matching Analysis.Infectious diseases & immunity · 2023Article
- Review
- Observational
- Respiratory viruses: their importance and lessons learned from COVID-19.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- National Research Institute of Tuberculosis and Lung Disease (NRITLD) Protocol for the Treatment of Patients with COVID-19.Iranian journal of pharmaceutical research : IJPR · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCritically ill patients with coronavirus disease 19 (COVID-19) have a high fatality rate likely due to a dysregulated immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose.
methodsThis is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from 12th March to 29th June 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the first 48 h of ICU admission) with those who did not receive early corticosteroids (delayed group) or any corticosteroids at all (never group). Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications.
resultsA total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n = 485) had lower ICU mortality (30.3% vs. never 36.6% and delayed 44.2%) and lower 7-day mortality (7.2% vs. never 15.2%) compared to non-early treated patients. They also had higher number of ventilator-free days, less length of ICU stay, and less secondary infections than delayed treated patients. There were no differences in medical complications between groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens.
conclusionEarly use of corticosteroids in critically ill patients with COVID-19 is associated with lower mortality than no or delayed use, and fewer complications than delayed use.
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.