Evidence map›Paper›PMID 34532398›Full record

ReviewAnnals of translational medicine2021

Tailoring glucocorticoids in patients with severe COVID-19: a narrative review.

Ming-Hao Luo, Yi-Qi Qian, Dan-Lei Huang, Jing-Chao Luo, Ying Su, Huan Wang, Shen-Ji Yu, Kai Liu, Guo-Wei Tu, Zhe Luo

Open access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 31% 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.

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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. 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

10 authors at 6 institutions in 1 country.

Ming-Hao LuoShanghai Medical College, Fudan University, Shanghai, China.
Yi-Qi QianDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Dan-Lei HuangShanghai Medical College, Fudan University, Shanghai, China.
Jing-Chao LuoDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Ying SuDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Huan WangDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Shen-Ji YuDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Kai LiuDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Guo-Wei TuDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhe LuoDepartment of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
The First Affiliated Hospital, Sun Yat-sen University · CNShanghai Medical College of Fudan University · CNFudan University · CNSun Yat-sen University · CNZhongshan Hospital · CNZhongshan Hospital of Xiamen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo discuss the pathogenesis of severe coronavirus disease 2019 (COVID-19) infection and the pharmacological effects of glucocorticoids (GCs) toward this infection. To review randomized controlled trials (RCTs) using GCs to treat patients with severe COVID-19, and investigate whether GC timing, dosage, or duration affect clinical outcomes. Finally. to discuss the use of biological markers, respiratory parameters, and radiological evidence to select patients for improved GC therapeutic precision.

backgroundCOVID-19 has become an unprecedented global challenge. As GCs have been used as key immunomodulators to treat inflammation-related diseases, they may play key roles in limiting disease progression by modulating immune responses, cytokine production, and endothelial function in patients with severe COVID-19, who often experience excessive cytokine production and endothelial and renin-angiotensin system (RAS) dysfunction. Current clinical trials have partially proven this efficacy, but GC timing, dosage, and duration vary greatly, with no unifying consensus, thereby creating confusion.

methodsPublications through March 2021 were retrieved from the Web of Science and PubMed. Results from cited references in published articles were also included.

conclusionsGCs play key roles in treating severe COVID-19 infections. Pharmacologically, GCs could modulate immune cells, reduce cytokine and chemokine, and improve endothelial functions in patients with severe COVID-19. Benefits of GCs have been observed in multiple clinical trials, but the timing, dosage and duration vary across studies. Tapering as an option is not widely accepted. However, early initiation of treatment, a tailored dosage with appropriate tapering may be of particular importance, but evidence is inconclusive and more investigations are needed. Biological markers, respiratory parameters, and radiological evidence could also help select patients for specific tailored treatments.

Indexed as

computed tomographyCoronavirus disease 2019 (COVID-19)C-reactive protein (CRP)cytokinesglucocorticoid (GC)

Identifiers

PMID34532398
PMCPMC8421952
OpenAlexW3182957670

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.