Trial reportRespiratory research2021
The efficacy of corticosteroids therapy in patients with moderate to severe SARS-CoV-2 infection: a multicenter, randomized, open-label trial.
Trial report in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025Pooled it
- Systemic corticosteroids for the treatment of COVID-19: Equity-related analyses and update on evidence.The Cochrane database of systematic reviews · 2022Pooled it
- EvidenceMap: a three-level knowledge representation for medical evidence computation and comprehension.Journal of the American Medical Informatics Association : JAMIA · 2023Trial
- The efficacy and safety of corticosteroids in treating severe COVID-19 patients: A meta-analysis with trial sequential analysis.Pakistan journal of medical sciences · 2025Review
- SARS-CoV2 variants differentially impact on the plasma metabolome.Metabolomics : Official journal of the Metabolomic Society · 2025Article
- Evaluating the Risk-Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review.Pharmacy (Basel, Switzerland) · 2024Article
- Impact of diabetes on COVID-19 and glucocorticoids on patients with COVID-19 and diabetes during the Omicron variant epidemic: a multicenter retrospective cohort study in South China.BMC infectious diseases · 2024Article
- Changes in Pharmacological Approach to COVID-19 in a Referral Hospital in Tehran During Two Years.Tanaffos · 2024Article
- Methylprednisolone therapy induces differential metabolic trajectories in severe COVID-19 patients.mSystems · 2023Article
- Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis.Global epidemiology · 2023Review
- Plausibility of natural immunomodulators in the treatment of COVID-19-A comprehensive analysis and future recommendations.Heliyon · 2023Review
- Long Term Treatment of Corticostreroids May Cause Hepatotoxicity and Oxidative Damage: A Case Controlled Study.Indian journal of clinical biochemistry : IJCB · 2023Article
- The evidence from clinical trials on Gout medicines effect on COVID-19: A protocol for systematic review and meta-analysis.Nursing open · 2023Article
- Glucocorticoid Therapy in COVID-19.Seminars in respiratory and critical care medicine · 2023Review
- Effect of Methylprednisolone on Mortality and Clinical Courses in Patients with Severe COVID-19: A Propensity Score Matching Analysis.Infectious diseases & immunity · 2023Article
- The Impact of Immune-Modulating Treatments for Dermatological Diseases on the Risk of Infection with SARS-CoV-2 and Outcomes Associated with COVID-19 Illness.Current dermatology reports · 2023Review
- New Insights on Effects of Glucocorticoids in Patients With SARS-CoV-2 Infection.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Review
- Application of Machine Learning in Hospitalized Patients with Severe COVID-19 Treated with Tocilizumab.Journal of clinical medicine · 2022Article
- Multiple Sclerosis Management During the COVID-19 Pandemic.Current neurology and neuroscience reports · 2022Review
- Prognostic peripheral blood biomarkers at ICU admission predict COVID-19 clinical outcomes.Frontiers in immunology · 2022Article
Corrections and comments
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Authors and funding
18 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe performed a multicenter, randomized open-label trial in patients with moderate to severe Covid-19 treated with a range of possible treatment regimens.
methodsPatients were randomly assigned to one of three regimen groups at a ratio of 1:1:1. The primary outcome of this study was admission to the intensive care unit. Secondary outcomes were intubation, in-hospital mortality, time to clinical recovery, and length of hospital stay (LOS). Between April 13 and August 9, 2020, a total of 336 patients were randomly assigned to receive one of the 3 treatment regimens including group I (hydroxychloroquine stat, prednisolone, azithromycin and naproxen; 120 patients), group II (hydroxychloroquine stat, azithromycin and naproxen; 116 patients), and group III (hydroxychloroquine and lopinavir/ritonavir (116 patients). The mean LOS in patients receiving prednisolone was 5.5 in the modified intention-to-treat (mITT) population and 4.4 days in the per-protocol (PP) population compared with 6.4 days (mITT population) and 5.8 days (PP population) in patients treated with Lopinavir/Ritonavir.
resultsThe mean LOS was significantly lower in the mITT and PP populations who received prednisolone compared with populations treated with Lopinavir/Ritonavir (p = 0.028; p = 0.0007). We observed no significant differences in the number of deaths, ICU admission, and need for mechanical ventilation between the Modified ITT and per-protocol populations treated with prednisolone and Lopinavir/Ritonavir, although these outcomes were better in the arm treated with prednisolone. The time to clinical recovery was similar in the modified ITT and per-protocol populations treated with prednisolone, lopinavir/ritonavir, and azithromycin (P = 0.335; P = 0.055; p = 0.291; p = 0.098).
conclusionThe results of the present study show that therapeutic regimen (regimen I) with low dose prednisolone was superior to other regimens in shortening the length of hospital stay in patients with moderate to severe COVID-19. The steroid sparing effect may be utilized to increase the effectiveness of corticosteroids in the management of diabetic patients by decreasing the dosage.
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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.