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The effect of corticosteroid treatment on patients with coronavirus infection : a systematic review and meta-analysis

OBJECTIVES: An outbreak of novel coronavirus in 2019 threatens the health of people, and there is no proven pharmacological treatment. Although corticosteroids were widely used during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, their efficacy remainedhighly controversial. We aimed to further evaluate the influence of corticosteroids on patients with coronavirus infection

METHODS: We conducted a comprehensive search of literature published in PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) from January 1, 2002 to March 15, 2020. All statistical analyses in this study were performed on stata14.0

RESULTS: A total of 5270 patients from 15 studies were included in this meta-analysis. The result indicated that critical patients were more likely to require corticosteroids therapy (risk ratio [RR] = 1.56, 95% confidence interval [CI] = 1.28-1.90, P<0.001). However, corticosteroid treatment was associated with higher mortality (RR = 2.11, 95%CI = 1.13-3.94, P = 0.019), longer length of stay (weighted mean difference [WMD] = 6.31, 95%CI = 5.26-7.37, P<0.001), a higher rate of bacterial infection (RR = 2.08, 95%CI = 1.54-2.81, P<0.001), and hypokalemia (RR = 2.21, 95%CI = 1.07-4.55, P = 0.032) but not hyperglycemia (RR = 1.37, 95%CI=0.68-2.76, P = 0.376) or hypocalcemia (RR = 1.35, 95%CI = 0.77-2.37, P = 0.302)

CONCLUSIONS: Patients with severe conditions are more likely to require corticosteroids. Corticosteroid use is associated with increased mortality in patients with coronavirus pneumonia

Comment in: J Infect. 2020 Aug;81(2):e89-e90. - PMID 32417314
Year of Publication: 2020
Contained in: The Journal of infection Vol. 81, No. 1 (2020), p. e13-e20
All journal articles: Search for all articles in this journal
Language: English
Contributors: Yang, Zhenwei | Author
Liu, Jialong
Zhou, Yunjiao
Zhao, Xixian
Zhao, Qiu
Liu, Jing
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: COVID-19
Coronavirus
Journal Article
Meta-Analysis
Meta-analysis
Research Support, Non-U.S. Gov't
Systematic Review
corticosteroid treatment
Additional Keywords: *Betacoronavirus
Adrenal Cortex Hormones
Coronavirus Infections
Humans
Pandemics
Pneumonia, Viral
ISSN: 1532-2742
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Completed 26.06.2020
Date Revised 26.06.2020
published: Print-Electronic
CommentIn: J Infect. 2020 Aug;81(2):e89-e90. - PMID 32417314
Citation Status MEDLINE
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    32283144
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1016/j.jinf.2020.03.062
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