Does adjunct corticosteroid therapy in community-acquired pneumonia decrease the need for invasive mechanical ventilation? A systematic review and meta-analysis

Abstract

<b>Background:</b> Adjunct corticosteroid therapy to patients with community-acquired pneumonia (CAP) remains controversial in clinical practice. We performed an updated systematic review and meta-analysis to assess the efficacy of corticosteroids in decreasing the need for invasive mechanical ventilation. <b>Methods:</b> We searched databases for randomized controlled trials&nbsp;from each database’s inception to February 2022. We estimated the risk ratios (RR) with their corresponding 95% confidence interval (CI) through the fixed or random-effects Mental-Haenszel model according to heterogeneity. I-squared statistics (I²) were used to evaluate heterogeneity. Publication bias was assessed with Begg’s and Egger’s tests. <b>Result:</b> We included 7 RCTs containing 2,054 patients with CAP. Adjunct corticosteroids&nbsp;was associated with significant reduction in need for invasive mechanical ventilation (RR = 0.55, CI = 0.38 – 0.79, p = 0.001, I² = 23.8%). No significant publication bias was observed with Begg’s (p = 0.368) and Egger’s tests (p = 0.194). <b>Conclusion:</b> Adjunct corticosteroid therapy significantly reduces the need for invasive mechanical ventilation in patients with CAP.