loading page

Effect of Corticosteroids therapy on mortality in the COVID-19 patients- A systematic review and Meta-analysis
  • +2
  • Chirag Patel,
  • Krupanshu Parmar,
  • Dipanshi Patel,
  • Sandip Patel,
  • Devang Sheth
Chirag Patel
LM College of Pharmacy

Corresponding Author:[email protected]

Author Profile
Krupanshu Parmar
LM College of Pharmacy
Author Profile
Dipanshi Patel
LM College of Pharmacy
Author Profile
Sandip Patel
LM College of Pharmacy
Author Profile
Devang Sheth
LM College of Pharmacy
Author Profile

Abstract

Background and Purpose: Corticosteroid therapy is still controversial to use for treatment of coronavirus disease-2019 (COVID-19). The results of multiple randomized clinical trials (RCTs) and observational studies are very diverse and contradictory, which arising difficulty in the clinical decision-making. The objective of this study is to investigate the effect of corticosteroids on mortality by systematic review and meta-analysis. External Approach: A systematic search was performed on different databases namely Medline/PubMed, Cochrane and Google scholar on 10 February 2022, according to PRISMA guidelines. The 28-days mortality was considered as outcome of study. A pooled estimate was calculated with random effects and fixed effects models. Cochran’s Q test and the I2 statistic were conducted for statistical heterogeneity. Key Results: 38 studies were included, having sample size of 87,781 patients. Amongst them, 16437 patients received corticosteroid therapy (intervention group) while 71344 patients were standard (noncorticosteroids) therapy (control group). 12.68% (2084) mortality observed in the intervention group while 5.93% (4227) mortality observed in the control group. The overall pooled estimate showed a significantly (OR2.305;95%CI: 2.1810 to 2.4370) increased mortality in intervention group. A pooled fold change estimation showed significantly increased in the mortality in methylprednisolone (OR 1.206;95%CI: 1.0770 to 1.3500) and dexamethasone (OR 1.388;95% CI:1.1870 to 1.6220) therapy. Conclusion and Implication: In conclusion, corticosteroid therapy produced a negative prognosis as depicted by increased mortality among COVID-19 patients. The possible reasons might be delay in virus clearance and secondary infection due to initiation of the corticosteroids at high dose in the early stage of infection.
Sep 2022Published in Reviews in Medical Virology volume 32 issue 5. 10.1002/rmv.2386