Are the steroids a blanket solution for COVID-19? A systematic review and meta-analysis

J Med Virol. 2021 Mar;93(3):1538-1547. doi: 10.1002/jmv.26483. Epub 2020 Sep 28.

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.

Keywords: coronavirus disease-2019; severe acute respiratory syndrome coronavirus-2; steroids.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 / drug therapy*
  • COVID-19 / mortality
  • Glucocorticoids / therapeutic use*
  • Humans
  • Length of Stay
  • SARS-CoV-2 / drug effects*
  • Treatment Outcome
  • Virus Shedding / drug effects

Substances

  • Glucocorticoids