Evaluating the Risk–Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions and Relevance
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Author (Year) | Country | No. of Participants | Dose | Duration | Outcomes | Results |
---|---|---|---|---|---|---|
Angus (2020) [19] | Australia, Belgium, Canada, Croatia, Finland, France, Germany, Hungary, Ireland, Netherlands, New Zealand, Portugal, Romania, Saudi Arabia, Spain, United Kingdom, United States | 576 |
|
| Organ-support-free days within 21 days |
|
Barros (2021) [20] | Brazil | 118 | IV MP 0.5 mg/kg was given twice daily | 5 days | Pulmonary function testing at day 120 follow-up visit | FEV1 and FVC were significantly higher in patients in the MP arm |
Batirel (2021) [21] | Turkey | 450 |
| 10 days | ICU stay |
|
Bouadma (2022) [22] | France | 546 |
| 10 days | 60-day mortality | HR: 0.96 [95% CI, 0.69–1.33] |
Corral-Gudino (2021) [23] | Spain | 64 | MP (40 mg twice daily for 3 days followed by 20 mg bid for 3 days) | 6 days | A composite of death, admission to the intensive care unit, or requirement for non-invasive ventilation |
|
Corral-Gudino (2023) [24] | Spain | 125 |
| MP: 3 days DEXA: 10 days | 28-day mortality |
|
Dastenae (2022) [25] | Iran | 143 |
| Maximum of 10 days | Length of hospital stay |
|
Dequin (2020) [26] | France | 149 | HC 200 mg/day until day 7 and then decreased to 100 mg/d for 4 days and 50 mg/day for 3 days | 14 days | 21-day mortality or respiratory support |
|
Edalatifard (2020) [4] | Iran | 68 | MP pulse 250 mg/day | 3 days | Time of clinical improvement or death | The percentage of improved patients was higher in the MP group compared to the standard care group (94.1% versus 57.1%), and the mortality rate was significantly lower in the MP group (5.9% versus 42.9%; p < 0.001) |
Ghanei (2021) [27] | Iran | 336 | Prednisolone 25 mg | 5 days | ICU admission | No difference between treatment and placebo groups |
Horby (2021) [1] | United Kingdom | 6425 | DEXA 6 mg once daily | Up to 10 days | 28-day mortality | RR: 0.64 [95% CI, 0.51 to 0.81] |
Jamaati (2021) [11] | Iran | 50 | DEXA 20 mg/day, days 1–5 and then 10 mg/day, days 6–10 | 10 days | Mortality |
|
Jeronimo (2020) [28] | Brazil | 393 | MP 0.5 mg/kg twice daily | 5 days | 28-day mortality | No difference between groups |
Maskin (2022) [29] | Argentina | 98 |
| 10 days | Ventilator-free days during the first 28 days | No difference between groups |
Munch (2021) [30] | Denmark, Sweden, Switzerland, India | 30 | HC 200 mg/day | Up to 7 days | Number of days alive without life support on day 28 |
|
Pinzón (2021) [31] | Colombia | 216 |
|
| Recovery time |
|
Ramakrishnan (2021) [32] | UK | 146 | Budesonide turbuhaler 400 μg per actuation, two puffs to be taken twice per day | Median at 7 days (4–10) | COVID-19-related urgent care visits, including emergency department assessment or hospitalisation |
|
Ranjbar (2021) [33] | Iran | 86 |
|
| 28-day mortality rate |
|
Salton (2022) [34] | Italy | 677 |
|
| 28-day mortality rate |
|
Salvarani (2022) [13] | Italy | 301 |
| 3 days | Duration of patient hospitalisation (median days) |
|
Soliman (2022) [7] | Egypt | 67 |
| 7 days | Monitoring of systemic inflammation through follow-up of NLR ratio at days 5, 7 | The NLR was significantly lower in the MP gr than the DEXA gr on the 5th and 7th days (p-values of 0.014 and 0.019, respectively) |
Tang (2021) [35] | China | 86 | MP group 1 mg/kg per day | 7 days | Incidence of clinical deterioration, 14 days | No significant differences between groups (4.8 vs. 4.8%, p = 1.000) |
Tomazini (2020) [2] | Brazil | 299 | DEXA 20 mg once daily, days 1–5, and then 10 mg once, days 6–10 or until ICU discharge | 10 days | Ventilator-free days during the first 28 days of hospital stay |
|
Toroghi (2021) [9] | Iran | 133 |
| Up to 10 days | 60-day survival rate | Longer in the low-dose group than the high-dose group (HR = 0.36, 95% CI = 0.15–0.83) |
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Tsai, D.H.-T.; Harmon, E.; Goelen, J.; Barry, H.E.; Chen, L.-Y.; Hsia, Y. Evaluating the Risk–Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review. Pharmacy 2024, 12, 129. https://doi.org/10.3390/pharmacy12040129
Tsai DH-T, Harmon E, Goelen J, Barry HE, Chen L-Y, Hsia Y. Evaluating the Risk–Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review. Pharmacy. 2024; 12(4):129. https://doi.org/10.3390/pharmacy12040129
Chicago/Turabian StyleTsai, Daniel Hsiang-Te, Emma Harmon, Jan Goelen, Heather E. Barry, Li-Yang Chen, and Yingfen Hsia. 2024. "Evaluating the Risk–Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review" Pharmacy 12, no. 4: 129. https://doi.org/10.3390/pharmacy12040129