3.2 Basic Characteristics of the Selected Studies:
The studies were conducted in China (n = 10)(25–34), Spain (n=7)(2,35–40), The United States of America (n = 6)(41–46), Italy (n=4)(47–50), Iran (n=3)(51–53), France (n=3)(9,54), Brazil (n=2)(55,56), Japan (n=1)(57), Turkey (n=1)(58), Netherlands (n=1)(59). The majority of studies were retrospective cohort studies (28/38) while10 studies were randomized controlled trials (Table-1).
A total 22 studies were demonstrated the beneficial effects of the corticosteroid therapy on the mortality in the COVID-19 patients(2,9,44–47,49,51,53,55,56,58,25,59,60,27,35,36,38,39,42,43). 14 studies were reported the increased in the corticosteroid therapy received COVID-19 patients(26,28,50,52,57,29,31–34,37,48,49)while 2 studies reported the neutral effects of the corticosteroid therapy on the mortality in the COVID-19 patients (41,54).
Four types of corticosteroid were used as single or multiple steroids individually including Methylprednisolone (n=24), Dexamethasone (n=5), Hydrocortisone (n=1), Prednisone (n=1), corticosteroid used individually including Methylprednisolone and Dexamethasone in the study (n=6) unknown corticosteroid (n=1) (Table-1).
In this review, total sample size was 87646 patients. Amongst them, 16437 patients were in the intervention group (Received corticosteroid therapy) while 71344patients were in the control group (Received standard treatment). A total 6374 patients were died in both groups. Among them, 2084 (12.68%) patientswere died in the intervention group and 4227(5.92%) patients were died in the control group. 28.93% and 25.24% mortality was observed in the methylprednisolone and standard treatment groups, respectively whereas 31.64% and 25.01% mortality was observed in the dexamethasone and standard treatment groups, respectively (Table-1).