SynthesisIntensive care medicine2025
Corticosteroids for adult patients hospitalised with non-viral community-acquired pneumonia: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled 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.
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
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of higher-dose versus lower-dose corticosteroids in community-acquired pneumonia: a systematic review and network meta-analysis.Critical care (London, England) · 2026Pooled it
- Ventilatory Parameters and Adjunctive Therapies Associated with ICU Mortality in Severe Pneumonia: A Large Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Corticosteroids in ARDS: old controversies, new insights, and future directions.Intensive care medicine · 2026Review
- Use of corticosteroids in sepsis and infectious diseases: a narrative review.The Korean journal of internal medicine · 2026Review
- Which issues should be addressed in future trials regarding the use of corticosteroids in community acquired pneumonia? A survey of REMAP-CAP investigators.Intensive care medicine · 2026Article
- GRP78 in viral pneumonia: dual regulatory mechanisms and translational prospects.Clinical and experimental medicine · 2026Review
- Article
- ARDS and corticosteroids: beyond COVID-19.Pneumonia (Nathan Qld.) · 2026Review
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Non-antimicrobial interventions in recovery from community-acquired pneumonia in adults.Current opinion in infectious diseases · 2026Review
- Systemic corticosteroids for severe community-acquired pneumonia: a narrative review of mechanisms and critical appraisal of recent trials in ICU.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Update on infection: from prevention to diagnosis and management.Intensive care medicine · 2026Article
- Biomarker-guided use of corticosteroids in pneumonia.Pneumonia (Nathan Qld.) · 2026Review
- Corticosteroids in severe community-acquired pneumonia: friend, foe or both?Pneumonia (Nathan Qld.) · 2026Review
- Glucocorticoid Treatment in Community-Acquired Pneumonia.Seminars in respiratory and critical care medicine · 2026Review
- Biomarker-concordant Steroid use in Hospitalized Patients with Community-acquired Pneumonia: A Prospective Cohort Study.The open respiratory medicine journal · 2026Article
- Severe community-acquired pneumonia: current concepts and controversies.Intensive care medicine · 2026Review
- Beyond mortality: a call for long-term outcomes in corticosteroid trials for CAP.Intensive care medicine · 2025Article
- Corticosteroids in sepsis: certainties and shadows.Intensive care medicine · 2025Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
28 authors.
Funding
Abstract
purposeInternational clinical practice guidelines addressing corticosteroid treatment for patients hospitalised with non-viral community-acquired pneumonia (CAP) are inconsistent.
methodsWe conducted a systematic review of randomized controlled trials (RCTs) evaluating the use of corticosteroids in hospitalised adult patients with suspected or probable CAP. We performed random effects pairwise, Bayesian, and dose-response meta-analyses using the restricted maximum likelihood (REML) heterogeneity estimator. We assessed certainty of evidence using GRADE methodology.
resultsWe identified 30 eligible RCTs, including a total of 7519 patients. The prednisone-equivalent doses ranged between 29 mg/day and 100 mg/day. Corticosteroids probably reduced short-term (28-30 days) mortality (RR 0.82 [95% CI 0.74-0.91]; moderate certainty) while the reduction in longer term (60-90 day) mortality is less certain (RR 0.89 [95% CI 0.76-1.03]; low certainty). Corticosteroids reduced the need for invasive mechanical ventilation (IMV) (RR 0.63 [95% CI 0.48-0.82]; high certainty) and may reduce duration of ICU stay (MD 1.53 days fewer [95% CI 0.31-2.75 days fewer]; low certainty), and hospital stay (MD 2.30 days fewer [95% CI 0.81-3.81 days fewer]; low certainty). Corticosteroids probably increased hyperglycaemia requiring intervention (RR 1.32 [95% CI 1.12-1.56]; moderate certainty) but probably have no effect on secondary infections (RR 0.97 [95% CI 0.85-1.11]; moderate certainty).
conclusionCorticosteroids probably reduced short-term mortality and reduce the need for invasive mechanical ventilation in hospitalised patients with CAP. PROSPERO REGISTRATION NUMBER: CRD42024521536.
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Registered trials
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