Systemic Steroids and Mortality Rate in Severe COVID-19 Infection: Systematic Review and Meta-analysis

Author(s): Zahra Ahmed Kheyami*, Saeed Saed Alharthi, Najah Saud Alanazi, Mohammad Ali Awad, Abdullah Mohammed Aldosari and Lojein Faisal Alnomari

Background: Evaluation of posted statistics including on this issue suggests that therapy with corticosteroids in the range of 6 mg of dexamethasone (or equivalent) in keeping with day possibly has an advantageous effect in patients requiring assisted ventilation but there remains considerable doubt in sufferers over the age of 70, in patients with diabetes and patients with milder sickness. Aim: This work aims to determine the safety of systemic steroids and mortality rate in severe COVID-19 patients. Materials and Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the Steroid group versus the Non-steroid group of COVID-19 patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on 28-day mortality rate as a primary outcome, and Serious Adverse Events (SAE rate) as a secondary outcome. Results: Seven studies were identified involving 2583 patients, with 1218 patients in the Steroid group, and 1365 patients in the Non-steroid group. The meta-analysis process revealed a highly significant decrease in the 28-day mortality rate and SAE rate in the Steroid group compared to the Non-steroid group (p < 0.001 respectively). Conclusion: To conclude, steroids have shown their usefulness in critically ill COVID19 patients. However, the efficacy of steroids and steroid dosage remains a matter of argument due to a lack of solid evidence and wide-ranging worries about benefits and harms. Further studies are needed to determine the optimal dosage and duration of steroid therapy which can reduce the mortality rate.


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