Evidence map›Paper›PMID 33612824›Full record

SynthesisSignal transduction and targeted therapy2021

Efficacy and safety of systematic corticosteroids among severe COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials.

Shaolei Ma, Changsheng Xu, Shijiang Liu, Xiaodi Sun, Renqi Li, Mingjie Mao, Shanwu Feng, Xian Wang

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Signal transduction and targeted therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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

48 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Guideline
  7. Pooled it
  8. Trial
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  19. Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shaolei MaDepartment of Emergency and Critical Care Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, China.
Changsheng XuDepartment of Emergency and Critical Care Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, China.
Shijiang LiuDepartment of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Xiaodi SunDepartment of Pain Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Renqi LiDepartment of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
Mingjie MaoDepartment of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
Shanwu FengDepartment of Anesthesiology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. iamfsw@163.com.
Xian WangDepartment of Anesthesiology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China. wangxian2002@126.com.ORCID 0000-0003-3922-9358

Funding

National Natural Science Foundation of China (National Science Foundation of China) 81600960National Natural Science Foundation of China (National Science Foundation of China) 81971045
6 · The paper itself

Abstract

The benefits and harms of corticosteroids for patients with severe coronavirus disease 2019 (COVID-19) remain unclear. We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials from December 31, 2019 to October 1, 2020 to identify randomized controlled trials (RCTs) that evaluated corticosteroids in severe COVID-19 patients. The primary outcome was all-cause mortality at the longest follow-up. Secondary outcomes included a composite disease progression (progression to intubation, ventilation, extracorporeal membrane oxygenation, ICU transfer, or death among those not ventilated at enrollment) and incidence of serious adverse events. A random-effects model was applied to calculate risk ratio (RR) with 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development, and Evaluation approach to evaluate the certainty of the evidence. Seven RCTs involving 6250 patients were included, of which the Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial comprised nearly 78% of all included subjects. Results showed that corticosteroids were associated with a decreased all-cause mortality (27.3 vs. 31.1%; RR: 0.85; 95% CI: 0.73-0.99; P = 0.04; low-certainty evidence). Trial sequential analysis suggested that more trials were still required to confirm the results. However, such survival benefit was absent if RECOVERY trial was excluded (RR: 0.83; 95% CI: 0.65-1.06; P = 0.13). Furthermore, corticosteroids decreased the occurrence of composite disease progression (30.6 vs. 33.3%; RR: 0.77; 95% CI: 0.64-0.92; P = 0.005), but not increased the incidence of serious adverse events (3.5 vs. 3.4%; RR: 1.16; 95% CI: 0.39-3.43; P = 0.79).

Indexed as

SARS-CoV-2Severity of Illness IndexAdrenal Cortex HormonesCOVID-19Disease-Free SurvivalHumansRandomized Controlled Trials as TopicSurvival RateAdrenal Cortex Hormones

Identifiers

PMID33612824
PMCPMC7897363

What OpenQuestion holds

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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.