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The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis.
J Infect. 2020 07; 81(1):e13-e20.JI

Abstract

OBJECTIVES

An outbreak of novel coronavirus in 2019 threatens the health of people, and there is no proven pharmacological treatment. Although corticosteroids were widely used during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, their efficacy remainedhighly controversial. We aimed to further evaluate the influence of corticosteroids on patients with coronavirus infection.

METHODS

We conducted a comprehensive search of literature published in PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) from January 1, 2002 to March 15, 2020. All statistical analyses in this study were performed on stata14.0.

RESULTS

A total of 5270 patients from 15 studies were included in this meta-analysis. The result indicated that critical patients were more likely to require corticosteroids therapy (risk ratio [RR] = 1.56, 95% confidence interval [CI] = 1.28-1.90, P<0.001). However, corticosteroid treatment was associated with higher mortality (RR = 2.11, 95%CI = 1.13-3.94, P = 0.019), longer length of stay (weighted mean difference [WMD] = 6.31, 95%CI = 5.26-7.37, P<0.001), a higher rate of bacterial infection (RR = 2.08, 95%CI = 1.54-2.81, P<0.001), and hypokalemia (RR = 2.21, 95%CI = 1.07-4.55, P = 0.032) but not hyperglycemia (RR = 1.37, 95%CI=0.68-2.76, P = 0.376) or hypocalcemia (RR = 1.35, 95%CI = 0.77-2.37, P = 0.302).

CONCLUSIONS

Patients with severe conditions are more likely to require corticosteroids. Corticosteroid use is associated with increased mortality in patients with coronavirus pneumonia.

Authors+Show Affiliations

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China.Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan 430071, China. Electronic address: liujing_GI@whu.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

32283144

Citation

Yang, Zhenwei, et al. "The Effect of Corticosteroid Treatment On Patients With Coronavirus Infection: a Systematic Review and Meta-analysis." The Journal of Infection, vol. 81, no. 1, 2020, pp. e13-e20.
Yang Z, Liu J, Zhou Y, et al. The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis. J Infect. 2020;81(1):e13-e20.
Yang, Z., Liu, J., Zhou, Y., Zhao, X., Zhao, Q., & Liu, J. (2020). The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis. The Journal of Infection, 81(1), e13-e20. https://doi.org/10.1016/j.jinf.2020.03.062
Yang Z, et al. The Effect of Corticosteroid Treatment On Patients With Coronavirus Infection: a Systematic Review and Meta-analysis. J Infect. 2020;81(1):e13-e20. PubMed PMID: 32283144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis. AU - Yang,Zhenwei, AU - Liu,Jialong, AU - Zhou,Yunjiao, AU - Zhao,Xixian, AU - Zhao,Qiu, AU - Liu,Jing, Y1 - 2020/04/10/ PY - 2020/03/30/received PY - 2020/03/31/accepted PY - 2020/4/14/pubmed PY - 2020/6/27/medline PY - 2020/4/14/entrez KW - COVID-19 KW - Coronavirus KW - Meta-analysis KW - corticosteroid treatment SP - e13 EP - e20 JF - The Journal of infection JO - J Infect VL - 81 IS - 1 N2 - OBJECTIVES: An outbreak of novel coronavirus in 2019 threatens the health of people, and there is no proven pharmacological treatment. Although corticosteroids were widely used during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, their efficacy remainedhighly controversial. We aimed to further evaluate the influence of corticosteroids on patients with coronavirus infection. METHODS: We conducted a comprehensive search of literature published in PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) from January 1, 2002 to March 15, 2020. All statistical analyses in this study were performed on stata14.0. RESULTS: A total of 5270 patients from 15 studies were included in this meta-analysis. The result indicated that critical patients were more likely to require corticosteroids therapy (risk ratio [RR] = 1.56, 95% confidence interval [CI] = 1.28-1.90, P<0.001). However, corticosteroid treatment was associated with higher mortality (RR = 2.11, 95%CI = 1.13-3.94, P = 0.019), longer length of stay (weighted mean difference [WMD] = 6.31, 95%CI = 5.26-7.37, P<0.001), a higher rate of bacterial infection (RR = 2.08, 95%CI = 1.54-2.81, P<0.001), and hypokalemia (RR = 2.21, 95%CI = 1.07-4.55, P = 0.032) but not hyperglycemia (RR = 1.37, 95%CI=0.68-2.76, P = 0.376) or hypocalcemia (RR = 1.35, 95%CI = 0.77-2.37, P = 0.302). CONCLUSIONS: Patients with severe conditions are more likely to require corticosteroids. Corticosteroid use is associated with increased mortality in patients with coronavirus pneumonia. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/32283144/The_effect_of_corticosteroid_treatment_on_patients_with_coronavirus_infection:_a_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(20)30191-2 DB - PRIME DP - Unbound Medicine ER -