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



Yousefifard M1 ; Mohamed Ali K2 ; Aghaei A3 ; Zali A4 ; Madani Neishaboori A1 ; Zarghi A5 ; Safari S6, 7 ; Hashemi B7 ; Forouzanfar MM7 ; Hosseini M8
Authors
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Authors Affiliations
  1. 1. Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
  2. 2. College of Medicine, University of Sulaimani, Sulaimani, Iraq
  3. 3. Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sci-ences, Sanandaj, Iran
  4. 4. Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Emergency Department, Shohadye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Public Health Published:2020

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 symp-toms 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. © 2020, Iranian Journal of Public Health. All rights reserved.
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