Abstract
Background: Irrational prescription of steroids in mild COVID-19 is on a rise. This systematic review and meta-analysis was conducted to assess the effect of steroids in mild COVID-19 patients, in terms of important outcomes. Methods: PubMed, EMBASE, Web of Science and Medrxiv were searched from inception to May-14, 2021, limiting randomised controlled trials (RCT) or propensity score matched (PSM) observational studies that reported the comparison of the effectiveness of steroids in terms of number of non-oxygen requiring COVID-19 patients progressing to severe disease, mortality (in-hospital or 28-day), duration of fever (in days), duration of viral clearance and length of hospital stay (in days); in the study arms with or without steroid use. Studies on inhalational steroids, case reports, letters, and reviews were excluded. Risk of bias was assessed by the Cochranes risk of bias tool for randomised trials and ROBANS tool. Quantitative data synthesis was done using the generic inverse variance method and the random-effects model. The study was prospectively registered in PROSPERO (CRD 42021254951). Findings: Seven studies were included, three RCT and four PSM controlled observational studies. Overall odds of progression to severe disease among the non-oxygen requiring COVID-19 patients receiving steroids was 5.97 (95%CI: 1.27 – 27.99, I2 - 0%), as compared to the patients not receiving steroids. Odds of death were higher in the steroid arm (OR: 1.35, 95%CI: 1.01 – 1.79; I2 – 0%). Mean duration of fever (7.4 days), duration to viral clearance (18.9 days), and length of hospital stay (20.8 days) was significantly higher in the steroid arm, as compared to that in the no-steroid arm (6.7 days, 16.5 days, 15.2 days respectively). Interpretation: Steroids in non-oxygen requiring COVID19 patients can be more detrimental than beneficial. Further research is required to identify the subset of patients who may benefit from early steroids. Registration Details: The study was prospectively registered in PROSPERO (CRD 42021254951). Funding Information: There are no funding sources. Declaration of Interests: Authors do not have any Conflict of Interest.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
