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Table 2 Summary of findings

From: Corticosteroid use in COVID-19 patients: a systematic review and meta-analysis on clinical outcomes

Outcomes

Total no events/total no of patients

Relative effect

(95% CI)

No of participants (studies)

Certainty of evidence

(Grade a)

Comments

Standard care

Corticosteroids

Effect of corticosteroids in hospitalized CoVID-19 patients. Intervention: Corticosteroids; Comparison: Standard of Care

In-hospital mortality

1547/9080

(17.0%)

1173/5234

(22.4%)

Estimate

0.72

(0.57–0.87)

14.187b

(22)

RCT: moderate

figure a

Non RCT: Very low

figure c

Corticosteroids reduce mortality in CoVID-19 hospitalized patients

Requirement of mechanical ventilation

124/467

(26,6%)

89/472

(18,9%)

Estimate

0.70

(0.54–0.91)

939

(7)

All studies: Very low

figure b

17 studies reported on mechanical ventilation, but effects could only be quantified in 7 studies

Descriptive results: Data too heterogeneous for quantification of effect

Viral Clearance

In corticosteroid group viral clearance time ranged from 10 to 29 days in corticosteroids group and from 8 to 24 days in standard of care group

2.556

(13)

0 × RCT

13 × retrospective observational study

Heterogeneous outcome reporting. Corticosteroids are associated with a probable delay in viral clearance

Length of hospital stay

Conflicting results both in favor and against the use of corticosteroids

9.433

(12)

2 × RCT,

10 × retrospective observational study

Effect of corticosteroids on length of hospital stay is uncertain

Mechanical ventilation

In 14 out of 17 studies, corticosteroids therapy is associated with beneficial effects on ventilator-free days, on respiratory failure requiring mechanical ventilation and time on mechanical ventilator

12.114

(17)

5 × RCT,

12 × retrospective observational study

Beneficial effects of corticosteroids on mechanical ventilation different definitions used)

Oxygenation

Outcome reporting in saturation, p/F ratio and oxygen demand. Conflicting results in favor and against the use of corticosteroids

3.211

(11)

1 × RCT,

10 × retrospective observational study

Outcome definition too heterogeneous to draw conclusions

Secondary infections

In five out of six studies, secondary infections and antibiotic use are increased

2.145

(6)

3 × RCT

3 × retrospective observational study

Corticosteroids are associated with an increase in infectious complications

  1. a Details on GRADE score are available in Additional file 10
  2. b Due to mortality analyses in subsets of patients, this number of participants is lower than the sum of sample sizes from the included study