Evidence map›Paper›PMID 33876268›Full record

SynthesisIntensive care medicine2021

Corticosteroids in COVID-19 and non-COVID-19 ARDS: a systematic review and meta-analysis.

Dipayan Chaudhuri, Kiyoka Sasaki, Aram Karkar, Sameer Sharif, Kimberly Lewis, Manoj J Mammen, Paul Alexander, Zhikang Ye, Luis Enrique Colunga Lozano, Marie Warrer Munch and 10 more

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

Synthesis in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06472219 (Early Prednisolone for Suspected Community-acquired Acute Respiratory Tract Infection), which is not on this map. Cited by 171 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 21 pooled it
35.1field-weighted citation impact, top 1% 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.

NCT06472219 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

Early Prednisolone for Suspected Community-acquired Acute Respiratory Tract Infection (PREDICATE): A Double-blind, Randomised, Multi-centre, Adaptive Platform, Controlled Trial

TypeinterventionalSponsorThe University of Hong KongRan2024 to 2028Enrolled1,300ConditionsRespiratory Tract InfectionsArmsPrednisolone 30 mg, Placebo
3 · Its place in the literature

Who cites it

171 citing papers in PubMed, 21 syntheses or guidelines pooled it, 295 citations in OpenAlex.

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  15. Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023
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  20. Use of steroids in COVID-19 patients: A meta-analysis.European journal of pharmacology · 2022
    Pooled it

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

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

20 authors at 10 institutions in 5 countries.

Dipayan ChaudhuriDepartment of Medicine, McMaster University, Hamilton, ON, Canada.ORCID http://orcid.org/0000-0002-8305-1481
Kiyoka SasakiDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Aram KarkarDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Sameer SharifDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Kimberly LewisDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Manoj J MammenDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Jacobs School of Medicine and Biological Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
Paul AlexanderDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Zhikang YeDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Luis Enrique Colunga LozanoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Marie Warrer MunchDept. of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Anders PernerDept. of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Bin DuMedical ICU, Peking Union Medical College Hospital, Beijing, China.
Lawrence MbuagbawDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Waleed AlhazzaniDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Stephen M PastoresCritical Care Center, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
John MarshallDepartment of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Canada.
François LamontagneDepartment of Medicine and Centre de Recherche du CHU de Sherbrooke, Sherbrooke, QC, Canada.
Djillali AnnaneFHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), RHU RECORDS (Rapid rEcognition of CORticosteroiD resistant or sensitive Sepsis), Department of Intensive Care, Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, Hôpital Raymond Poincaré (APHP), University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, France.
Gianfranco Umberto MeduriMemphis Veterans Affairs Medical Center Research Service and Pulmonary, Critical Care, and Sleep Medicine Service, Memphis, TN, USA.
Bram RochwergDepartment of Medicine, McMaster University, Hamilton, ON, Canada. rochwerg@mcmaster.ca.
Impact · CAMcMaster University · CAUniversity of Copenhagen · DKCentre Hospitalier Universitaire de Sherbrooke · CAChinese Academy of Medical Sciences & Peking Union Medical College · CNInserm · FRJuravinski Hospital · CAMemorial Sloan Kettering Cancer Center · USSt. Michael's Hospital · CAUniversity at Buffalo, State University of New York · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

purposeCorticosteroids are now recommended for patients with severe COVID-19 including those with COVID-related ARDS. This has generated renewed interest regarding whether corticosteroids should be used in non-COVID ARDS as well. The objective of this study was to summarize all RCTs examining the use of corticosteroids in ARDS.

methodsThe protocol of this study was pre-registered on PROSPERO (CRD42020200659). We searched online databases including MEDLINE, EMBASE, CDC library of COVID research, CINAHL, and COCHRANE. We included RCTs that compared the effect of corticosteroids to placebo or usual care in adult patients with ARDS, including patients with COVID-19. Three reviewers abstracted data independently and in duplicate using a pre-specified standardized form. We assessed individual study risk of bias using the revised Cochrane ROB-2 tool and rated certainty in outcomes using GRADE methodology. We pooled data using a random effects model. The main outcome for this review was 28-day-mortality.

resultsWe included 18 RCTs enrolling 2826 patients. The use of corticosteroids probably reduced mortality in patients with ARDS of any etiology (2740 patients in 16 trials, RR 0.82, 95% CI 0.72-0.95, ARR 8.0%, 95% CI 2.2-12.5%, moderate certainty). Patients who received a longer course of corticosteroids (over 7 days) had higher rates of survival compared to a shorter course.

conclusionThe use of corticosteroids probably reduces mortality in patients with ARDS. This effect was consistent between patients with COVID-19 and non-COVID-19 ARDS, corticosteroid types, and dosage.

Indexed as

COVID-19Respiratory Distress SyndromeAdrenal Cortex HormonesAdultHumansRespiration, ArtificialSARS-CoV-2Adrenal Cortex HormonesARDSCorticosteroidsCOVID-19Mechanical ventilation

Identifiers

PMID33876268
PMCPMC8054852
OpenAlexW3154855659

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.