Skip to main content

Table 1 Limitations in the RECOVERY trial and the meta-analysis

From: Corticosteroids in severe COVID-19: a critical view of the evidence

Study Limitations
RECOVERY trial [7] No stratification between centers
  BMI, ethnicity not reported
  Location of patient at randomization unknown (ward/ICU)
  Age imbalance in the study population
  Distribution of the various factors associated with outcome not reported for the different subgroups
  For patients receiving mechanical ventilation, PEEP, FiO2, PaO2/FiO2 not reported
  Short-term outcome (28-day mortality) reported
Meta-analysis [11] Selected data only were included
  Some of the trials were stopped prematurely and underpowered
  Excessive weight (57%) of a single trial (RECOVERY) with its own limitations see above
  Imbalance in age and sex in favor of dexamethasone in the CODEX trial, which accounted for 19% of weight
  Imbalance in age and BMI in favor of hydrocortisone in the CAPE COVID trial which accounted for 7% of weight
  Selected patients from the REMAP CAP trial were included, increasing the mortality difference from 2 to 7%. This trial accounted for 12% of weight
  Conflicting results for the subgroups of mechanical ventilation versus no ventilation between meta-analysis and RECOVERY trial
  Short-term outcomes only considered (21- to 28-day mortality)