Author: Zhan, Yuan; Shang, Jin; Gu, Yiya; Huang, Qian; Xie, Jungang
Title: Efficacy of corticosteroid in patients with COVIDâ€19: a multiâ€center retrospective study and metaâ€analysis Cord-id: es54ajmv Document date: 2021_3_5
ID: es54ajmv
Snippet: PURPOSE: To evaluate the efficacy of corticosteroids on COVIDâ€19 patients with different levels of disease severity. METHODS: In our multicenter study, 543 patients with confirmed COVIDâ€19 were classified as Nonâ€severe group and Severe group, and then were compared respectively for allâ€cause mortality and length of hospital stay between those who received corticosteroids and not. By searching in PubMed, Web of Science, Embase and CNKI, we identified 13 retrospective studies and 6 random
Document: PURPOSE: To evaluate the efficacy of corticosteroids on COVIDâ€19 patients with different levels of disease severity. METHODS: In our multicenter study, 543 patients with confirmed COVIDâ€19 were classified as Nonâ€severe group and Severe group, and then were compared respectively for allâ€cause mortality and length of hospital stay between those who received corticosteroids and not. By searching in PubMed, Web of Science, Embase and CNKI, we identified 13 retrospective studies and 6 random control trials eligible for criteria of inclusion, and conducted comprehensive metaâ€analyses assessing the impacts of corticosteroids on mortality, length of stay, duration of RNA clearance and duration of fever. RESULTS: Our multicenter study demonstrated that lowâ€dose corticosteroids can reduce mortality in the multivariable Cox regression analysis for severe patients(p=0.03), while presented no influence in univariable analysis for nonâ€severe patients(p=0.14). From multivariable analyses, patients with corticosteroids in nonâ€severe group had longer duration of hospitalization(p=0.003), but did not in severe group(p=0.18). Moreover, for severe patients, corticosteroids can evidently shorten duration of fever. The same results were summarized in the metaâ€analyses supplemented with the result that corticosteroids delayed viral clearing in nonâ€severe patients. CONCLUSION: Corticosteroids should be considered based on patient's condition. For patients with nonâ€severe COVIDâ€19, corticosteroid was not recommended as a routine therapeutic initiative as that presented prolonged duration of hospitalization and delayed viral clearing, as well as no positive impact on prognosis. While lowâ€dose corticosteroids may benefit patients with severe COVIDâ€19 for it can manifestly lower risk of death and improve the clinical status to some extent. This article is protected by copyright. All rights reserved.
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