Evidence map›Paper›PMID 34979235›Full record

SynthesisPharmacological research2022

Systemic administration of glucocorticoids, cardiovascular complications and mortality in patients hospitalised with COVID-19, SARS, MERS or influenza: A systematic review and meta-analysis of randomised trials.

Elisabetta Caiazzo, Asma O M Rezig, Dario Bruzzese, Armando Ialenti, Carla Cicala, John G F Cleland, Tomasz J Guzik, Pasquale Maffia, Pierpaolo Pellicori

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Pharmacological research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.0field-weighted citation impact, top 21% 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

12 citing papers in PubMed, 18 citations in OpenAlex.

  1. Anti-GPV activity ofFrontiers in microbiology · 2026
    Article
  2. Observational
  3. Review
  4. Metabolomic heterogeneity of ageing with ethnic diversity: a step closer to healthy ageing.Metabolomics : Official journal of the Metabolomic Society · 2024
    Article
  5. Observational
  6. Observational
  7. Review
  8. Article
  9. Review
  10. Glucocorticoids and COVID-19.Pharmacological research · 2022
    Review
  11. Review
  12. 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

9 authors at 3 institutions in 3 countries.

Elisabetta CaiazzoCentre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Asma O M RezigCentre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
Dario BruzzeseDepartment of Public health, University of Naples Federico II, Naples, Italy.
Armando IalentiDepartment of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Carla CicalaDepartment of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy.
John G F ClelandRobertson Centre for Biostatistics, and Glasgow Clinical Trials Unit, Institute of Health and Wellbeing, University of Glasgow, UK; National Heart & Lung Institute, Imperial College London, UK.
Tomasz J GuzikInstitute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Krakow, Poland.
Pasquale MaffiaCentre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy; Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK. Electronic address: Pasquale.Maffia@glasgow.ac.uk.
Pierpaolo PellicoriRobertson Centre for Biostatistics, and Glasgow Clinical Trials Unit, Institute of Health and Wellbeing, University of Glasgow, UK. Electronic address: pierpaolo.pellicori@glasgow.ac.uk.
University of Glasgow · GBUniversity of Naples Federico II · ITImperial College London · GB

Funding

British Heart Foundation PG/19/84/34771British Heart Foundation PG/21/10541British Heart Foundation PG/21/10634European Research Council
6 · The paper itself

Abstract

backgroundAdministration of glucocorticoids might reduce mortality in patients with severe COVID-19 but have adverse cardiometabolic effects.

objectivesto investigate the effect of systemic administration of glucocorticoids on cardiovascular complications and all-cause mortality in patients hospitalised with respiratory viral infections, including COVID-19, SARS, MERS and influenza.

methodsWe identified randomised trials published prior to July 28th, 2021. The Mantel-Haenszel random effects method and the Hartung and Knapp adjustment were used to obtain pooled estimates of treatment effect with 95% confidence intervals.

resultsNo randomised trials of glucocorticoids for SARS, MERS or influenza reported relevant outcomes. We included eleven COVID-19 randomised trials (8109 patients). Overall, compared to placebo or standard care, glucocorticoids were not associated with a reduction of in-hospital mortality (p = 0.09). In a pre-specified sub-analysis, in-hospital mortality was reduced by 19% when follow-up was restricted to 14 days from randomisation (5/11 trials, 1329 patients, p = 0.02). With longer follow-up (9/11 trials, 7874 patients), administration of glucocorticoids was associated with a trend to benefit for those requiring mechanical ventilation (RR 0.86; 95% CI 0.57-1.27) but possible harm for those not receiving oxygen at randomisation (RR 1.27; 95% CI 1.00 - 1.61), an effect that was significantly different amongst subgroups (p = 0.0359). Glucocorticoids reduced the risk of worsening renal function by 37% (4/11 trials); reported rate of other cardiovascular complications was low.

conclusionsAdministration of systemic glucocorticoids to patients hospitalised with COVID-19 does not lower mortality overall but may reduce it in those requiring respiratory support and increase it in those who do not.

Indexed as

COVID-19 Drug TreatmentCardiovascular DiseasesCOVID-19GlucocorticoidsHospitalizationHumansInfluenza, HumanRandomized Controlled Trials as TopicSARS-CoV-2Severe Acute Respiratory SyndromeGlucocorticoidsCOVID-19DexamethasoneGlucocorticoidsMeta-analysisMortalitySteroids

Identifiers

PMID34979235
PMCPMC8719379
OpenAlexW4205143932

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.