Corticosteroids on the Management of Coronavirus Disease 2019 (COVID-19): A Systemic Review and Meta-Analysis

  • Mahmoud Yousefifard Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
  • Kosar Mohamed Ali College of Medicine, University of Sulaimani, Sulaimani, Iraq
  • Abbas Aghaei Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sci-ences, Sanandaj, Iran
  • Alireza Zali Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Arian Madani Neishaboori Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
  • Afshin Zarghi Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Saeed Safari 1. Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2. Emergency Department, Shohadye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Teh-ran, Iran
  • Behrooz Hashemi Emergency Department, Shohadye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohammad Mehdi FOROUZANFAR Emergency Department, Shohadye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mostafa Hosseini Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Keywords:
Coronavirus, Coronavirus Infections, Glucocorticoids, Methylprednisolone

Abstract

Background: We aimed to examine the available evidence regarding the efficacy and safety of corticosteroids on the management of coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV).

Method: An extensive search was conducted in Medline, Embase, and Central databases until the end of March 2020, using keywords related to corticosteroids, COVID-19, SARS-CoV and MERS-CoV. The main outcome was considered to be the mortality rate, length of stay, virus clearance time, symptom improvement, and lung function improvement. The findings are presented as odds ratio (OR) with 95% confidence interval (95% CI).

Results: Fifteen paper compromising 5 studies on COVID-19, 8 studies on SARS-CoV and 2 studies on MERS-CoV were included. One study was clinical trial and the rest were cohort. The analyses showed that corticosteroids were not reduce the mortality rate of COVID-19 (OR=1.08; 95% CI: 0.34 to 3.50) and SARS-CoV (OR=0.77; 95% CI: 0.34 to 1.3) patients, while they were associated with higher mortality rate of patients with MERS-CoV (OR = 2.52; 95% CI: 1.41 to 4.50). Moreover, it appears that corticosteroids administration would not be effective in shortening viral clearance time, length of hospitalization, and duration of relief symptoms following viral severe acute respiratory infections.

Conclusion: There is no evidences that corticosteroids are safe and effective on the treatment of severe acute respiratory infection when COVID-19 disease is suspected. Therefore, corticosteroids prescription in COVID-19 patients should be avoided.

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Published
2020-07-30
How to Cite
1.
Yousefifard M, Ali K, Aghaei A, Zali A, Madani Neishaboori A, Zarghi A, Safari S, Hashemi B, FOROUZANFAR MM, Hosseini M. Corticosteroids on the Management of Coronavirus Disease 2019 (COVID-19): A Systemic Review and Meta-Analysis. Iran J Public Health. 49(8):1411-1421.
Section
Review Article(s)