Evidence map›Paper›PMID 39323444›Full record

ArticleWorld journal of virology2024

Dosage and utilization of dexamethasone in the management of COVID-19: A critical review.

Imran Sethi, Asim Shaikh, Musa Sethi, Hira Khalid Chohan, Sheraz Younus, Syed A Khan, Salim Surani

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Article in World journal of virology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

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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

7 authors.

Imran SethiDepartment of Critical Care Medicine, Marion General Hospital, Marion, IN 46952, United States.
Asim ShaikhDepartment of Medicine, Aga Khan University, Karachi 74200, Sindh, Pakistan.
Musa SethiDepartment of Medicine, Eman School, Fishers, IN 46038, United States.
Hira Khalid ChohanDepartment of Internal Medicine, Dow University of Health Science, Karachi 74200, Sindh, Pakistan.
Sheraz YounusDepartment of Hospital Medicine, Franciscan Health, Indianapolis, IN 46237, United States.
Syed A KhanDepartment of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States.
Salim SuraniDepartment of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States. srsurani@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe severe respiratory manifestations observed in severe coronavirus disease 2019 (COVID-19) cases are often associated with an excessive inflammatory response. Dexamethasone, a synthetic glucocorticoid, exerts its anti-inflammatory effects by inhibiting the transcription of pro-inflammatory genes and suppressing the activity of various immune cells. This mechanism has implications for mitigating the cytokine storm observed in severe COVID-19 cases. Early on in the pandemic, the Recovery Collaborative working group showed a mortality benefit of using dexamethasone in decreasing mortality in patients with COVID-19 requiring respiratory support. However, the optimal dosage of corticosteroids remains debatable. Several studies that compare different doses of dexamethasone in COVID-19 exist, but the results are conflicting.

aimTo review the latest evidence regarding dosage, safety, and efficacy of dexamethasone in severe COVID-19.

methodsWe followed preferred reporting items for systematic reviews and meta-analysis guidelines. A detailed literature search was conducted across PubMed, Google Scholar, and Medline to include publications up to March 2024. Our keywords included "COVID-19" "SARS-CoV-2" "dexamethasone" "corticosteroid" "steroid" and "glucocorticoid"-along with their combinations. We employed the Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale to evaluate the integrity and potential of bias in the included studies. A meta-analysis was conducted using a random-effects model, assessing pooled odds ratios and mean differences, with heterogeneity gauged by the

resultsNo statistical differences were found in 28-day all-cause mortality [pooled odds ratio (OR) = 1.109, 95%CI: 0.918-1.340], 60-day all-cause mortality (OR = 0.873, 95%CI: 0.744-1.024;

conclusionDiffering doses of corticosteroids have no clinical implications on mortality, mean length of hospital stay, and adverse events in COVID-19 patients. Additional research is required in patients requiring invasive or non-invasive ventilation.

Indexed as

Corona virusCorticosteroidsCOVID-19Critical careSteroid dosageSteroids

Identifiers

PMID39323444
PMCPMC11401006

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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.