Abstract
Background There are controversial suggestions about steroid use to treat patients infected with COVID-19. Conclusive evidence regarding the use of steroids to treat COVID-19 is still lacking. This meta-analysis aimed to determine the mortality and severity associated with corticosteroid therapy compared to noncorticosteroid treatment in patients with COVID-19. Methods The information was collected from electronic databases: PubMed, CINAHL, the Cochrane Library, clinicaltrials.gov, and Google scholar through January 30, 2021. Risk ratios (RRs) with 95% confidence intervals (CIs) were performed using random effect models. Endnote citation manager software version X9 for Windows was utilized to collect and organize search outcomes (into relevant and irrelevant studies) and to remove duplicate articles. Results Thirty-two studies were included in the meta-analysis, including 14,659 COVID-19 patients. No significant differences in mortality between the steroid and nonsteroid treatment groups (RR = 0.95; 95% CI: 0.80–1.13; p = 0.57). There was no significant reduction in mortality in critically ill COVID-19 patients treated with corticosteroid (RR = 0.89; 95% CI: 0.62–1.27; p = 0.52). Significant differences were observed in severe disease conditions between the steroid and nonsteroid treatment groups (RR = 1.10; 95% CI, 1.03–1.19, p = 0.007). Conclusion There was no significant difference in all-cause mortality between the steroid and nonsteroid treatment users' of COVID-19 patients. There was no significant reduction of all-cause mortality in critically ill COVID-19 patients treated with corticosteroids.
Highlights
Coronavirus disease-19 (COVID-19) was first identified at the end of 2019 in Wuhan City, China
Erefore, this study aims to summarize the current evidence of the severity and mortality associated with steroid therapy for patients with COVID-19 which will support us in making the best decision in the management of the COVID-19
Search Strategy. e information was collected from electronic databases: PubMed, CINAHL, the Cochrane Library, clinicaltrial.gov, and Google scholar. ere was no limitation applied to the language. e reference list of all identified articles was searched for additional studies. en, an extensive list of search terms was prepared by the analysis of title, abstract, and keywords of retrieved articles
Summary
Coronavirus disease-19 (COVID-19) was first identified at the end of 2019 in Wuhan City, China. It rapidly spread in China and other countries throughout the world [1, 2]. In March 2020, the World Health Organization characterized the disease as pandemic [3]. As of May 21, 2020, more than five million confirmed cases have been documented and several death cases reported globally. It is affecting 213 countries and territories around the world and 2 international conveyances [4]. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is identified as the cause of COVID-19 [5]
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