VolumeVol. 59 • Number No. 3 • July - September 2021 Back

Original Article

Efficacy and Safety of Corticosteroid Administration in Moderate to Severe COVID-19: A Meta-analysis

Authors: Erika Xandra N. Talamayan, Alena Pias Bantolo, Clarissa M. Mendoza

DOI: 10.65564/pjim.10fd5ff5c7

Date of Publication: September 2021


Abstract

Background. Adding to the current available evidence on the efficacy of exogenous corticosteroids as an adjunct to standard of care in improving the clinical outcomes of COVID-19 patients. This meta-analysis examined the experimental and clinical data supporting this therapeutic intervention in improving clinical outcomes.

Objectives. This meta-analysis aimed to assess the efficacy of corticosteroids in improving outcomes in COVID-19 patients.

Search methods. Literature searches of electronic databases (PubMed, Cochrane Library, Science Direct, Google Scholar) were performed to identify relevant studies.

Data Collection and Analysis. Meta-analysis was performed using Review Manager (RevMan) software, version 5.4.1. Intervention effects were expressed in terms of mean differences and risk ratios for continuous and dichotomous variables, respectively. Fixed-effect or random-effects model was adopted according to heterogeneity.

Main Results. A total of seven studies were included in the quantitative synthesis. Analysis of pooled data showed a 12% reduced risk of mortality in COVID patients given corticosteroids (RR 0.88, 95% CI 0.81 to 0.95). Patients who were administered with corticosteroids also had 22% decreased risk of requiring invasive ventilation support (RR 0.78, 95% CI 0.64 to 0.95). Number of adverse events were similar between the two groups (RR 1.10, 95% CI 0.49 to 2.46).

Conclusion. Adjunct corticosteroid therapy provided improvements in clinical outcomes such as decreased deaths and decreased need for invasive ventilation support. There was no sufficient evidence of a significant adverse effect, hence it is relatively safe and beneficial to use in COVID19 patients.

Keywords. Corticosteroids, COVID-19, meta-analysis, clinical outcomes


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