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Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use : a systematic review and meta-analysis

OBJECTIVES: The acute respiratory distress syndrome (ARDS) secondary to viral pneumonitis is one of the main causes of high mortality in COVID-19 patients. We systematically reviewed ARDS-associated mortality and the potential role of systemic corticosteroids in COVID-19 patients

METHODS: Electronic databases and country-specific reports were searched to identify relevant studies. The mortality data from these studies were pooled for statistical analysis, and subgroup analysis and quality assessment were performed

RESULTS: The overall pooled mortality among 10,815 ARDS cases in COVID-19 patients was 39% (95% CI: 23-56%). The pooled mortality for China was 69% (95% CI: 67-72%). In Europe, the highest mortality among COVID-19 patients with ARDS was reported in Poland (73%; 95% CI: 58-86%) while Germany had the lowest mortality (13%; 95% CI: 2-29%). The median crude mortality rate of COVID-19 patients with reported corticosteroid use was 28.0% (lower quartile: 13.9%; upper quartile: 53.6%)

CONCLUSIONS: The high mortality in COVID-19 associated ARDS necessitates a prompt and aggressive treatment strategy including corticosteroids. Most of the studies included no information on the dosing regimen of corticosteroid therapy, however, low-dose corticosteroid therapy or pulse corticosteroid therapy appears to have a beneficial role in the management of severely ill COVID-19 patients

Year of Publication: 2020
Contained in: Expert review of respiratory medicine (31.07.2020)
All journal articles: Search for all articles in this journal
Language: English
Contributors: Hasan, Syed Shahzad | Author
Capstick, Toby
Ahmed, Raees
Kow, Chia Siang
Mazhar, Faizan
Merchant, Hamid A
Zaidi, Syed Tabish Razi
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: Acute respiratory distress syndrome
Journal Article
coronavirus disease 2019
corticosteroids
mortality
ISSN: 1747-6356
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Revised 31.07.2020
published: Print-Electronic
Citation Status Publisher
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    32734777
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1080/17476348.2020.1804365
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520 |a METHODS: Electronic databases and country-specific reports were searched to identify relevant studies. The mortality data from these studies were pooled for statistical analysis, and subgroup analysis and quality assessment were performed 
520 |a RESULTS: The overall pooled mortality among 10,815 ARDS cases in COVID-19 patients was 39% (95% CI: 23-56%). The pooled mortality for China was 69% (95% CI: 67-72%). In Europe, the highest mortality among COVID-19 patients with ARDS was reported in Poland (73%; 95% CI: 58-86%) while Germany had the lowest mortality (13%; 95% CI: 2-29%). The median crude mortality rate of COVID-19 patients with reported corticosteroid use was 28.0% (lower quartile: 13.9%; upper quartile: 53.6%) 
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