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COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Treatment Veronese N, Demurtas J, Yang L, et al. Use of Corticosteroids in Coronavirus Disease 2019 Pneumonia: A Systematic Review of the Literature. Front Med (Lausanne). 2020 Apr 24;7:170. doi: 10.3389/fmed.2020.00170. eCollection 2020.
Abstract

The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. However, one study, on 201 participants with different stages of pneumonia due to COVID-19, found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%. The literature to date does not fully support the routine use of corticosteroids in COVID-19, but some findings suggest that methylprednisolone could lower mortality rate in more severe forms of the condition.

Ratings
Discipline / Specialty Area Score
Hospital Doctor/Hospitalists
Internal Medicine
Respirology/Pulmonology
Intensivist/Critical Care
Infectious Disease
Comments from MORE raters

Intensivist/Critical Care rater

A review of the rapidly evolving data, which are little more than small observational series, might be of interest but could hardly be expected to provide a guide to therapy.

Respirology/Pulmonology rater

The number of patients in the study is relatively small compared with the total number of patients with the disease.

Respirology/Pulmonology rater

Important importation, since the treatment of COVID-19 is a work in progress. This paper provides important information regarding the use of corticosteroids in the disease. The use of corticosteroids in severe cases reduced mortality by 62%.