COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Treatment Sarkar S, Khanna P, Soni KD Are the steroids a blanket solution for COVID-19? A systematic review and meta-analysis. J Med Virol. 2020 Sep 3. doi: 10.1002/jmv.26483.
Abstract

Steroids may play a critical role in the current pandemic of coronavirus disease-2019 (COVID-19), given the dearth of specific therapeutic options. This review was conducted to evaluate the impact of glucocorticoid therapy in patients with COVID-19 based on the publications reported to date. A comprehensive screening was conducted using electronic databases up to August 19, 2020. The randomized controlled trials (RCTs) and cohort studies evaluating the effectiveness and safety of steroids in patients with COVID-19 are included for the meta-analyses. Our search retrieved twelve studies, including two RCTs and 10 cohort studies, with a total of 15,754 patients. In patients with COVID-19, the use of systemic glucocorticoid neither reduce mortality (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.11-3.4, I2 = 96%), nor the duration of hospital stay (mean difference [MD] = 1.18 days, 95% CI: -1.28 to 3.64, I2 = 93%) and period of viral shedding (MD = 1.42 days, 95% CI: -0.52 to 3.37, I2 = 0%). Systemic steroid therapy may not be effective for reducing mortality, duration of hospitalization, and period of viral shedding. Studies are mostly heterogeneous. Further RCTs are required.

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

Intensivist/Critical Care rater

We used to give steroids to patients with severe inflammation. COVID-19 is well known as a severe inflammatory disease, which may cause RDS, myocarditis, sepsis and so forth. In this literature, the authors analyzed the effect of steroids to COVID-19 but steroids did not work. It could not shorten hospitalization and reduce mortality. However, steroid is accepted as therapeutic medicine and we usually use steroid on patients with severe inflammation. We need a RCT on the use of steroid to treat COVID-19.