Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis

BackgroundCOVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19. MethodsPubMed, Web of Science, Scopus, Cochrane...

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Published in:Global Epidemiology 2023-12, Vol.6, p.100116-100116, Article 100116
Main Authors: Morsali, Mina, Doosti-Irani, Amin, Amini, Shahideh, Nazemipour, Maryam, Mansournia, Mohammad Ali, Aliannejad, Rasoul
Format: Article
Language:English
Subjects:
COVID-19
Dexamethasone
Hydrocortisone
Methylprednisolone
Network meta-analysis
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Summary:BackgroundCOVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19. MethodsPubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the corticosteroid drugs were included. The hazard ratio (HR) with a 95% confidence interval (CI) was used to summarize the effect size from the network meta-analysis (NMA). ResultsOut of 329 retrieved references, 12 RCTs with 11,455 participants met the eligibility criteria in this review. The included RCTs formed one network with six treatments. In addition, five treatments in two RCTs were not connected to the network. Methylprednisolone + usual care (UC) versus UC decreased the risk of death by 0.65 (95% CI: 0.47, 0.90). Among treatments in the network the highest P-score (0.89) was related to Methylprednisolone + UC. ConclusionBased on the results of this NMA it seems Methylprednisolone + UC to be the best treatment option in patients with COVID-ARDS and COVID pneumonia.
ISSN:2590-1133
2590-1133
DOI:10.1016/j.gloepi.2023.100116