tetano
Editor, Senior Moderator
Int J Infect Dis
. 2022 Oct 19;S1201-9712(22)00557-4.
doi: 10.1016/j.ijid.2022.10.021. Online ahead of print.
Effect of Corticosteroids in Patients with COVID-19: A Bayesian Network Meta-analysis: Corticosteroids in COVID-19
Xing Wang[SUP] 1 [/SUP], Dingke Wen[SUP] 1 [/SUP], Qiang He[SUP] 1 [/SUP], Jingguo Yang[SUP] 1 [/SUP], Chao You[SUP] 2 [/SUP], Chuanyuan Tao[SUP] 1 [/SUP], Lu Ma[SUP] 3 [/SUP]
Affiliations
Abstract
Objectives: We sought to perform a network meta-analysis to compare the safety and efficacy of the systemic administration for treating corticosteroids for coronavirus disease 2019 (COVID-19).
Methods: Bayesian network meta-analysis was performed to combine direct and indirect evidence. The surface under the cumulative ranking curve (SUCRA) was obtained to estimate the ranking probability of the treatment agents for each outcome. The efficacy outcome was 28-day all-cause mortality. The safety outcome was serious adverse events.
Results: A total of 16 trials with 2,992 patients comparing four treatments (dexamethasone, hydrocortisone, methylprednisolone, and placebo) were identified. Direct analysis showed that corticosteroids were associated with a reduced risk of 28-day mortality compared with usual care (RR, 0.83; 95% CI, 0.70-0.99). Network analysis showed that the pooled RR was 0.63 (95% CrI, 0.39-0.93) for all-cause mortality at 28 days when comparing methylprednisolone with usual care or placebo (SUCRA: 91%). Our analysis demonstrated that patients who received low dose of corticosteroids (RR, 0.80; 95% CrI, 0.70-0.91) and long course of treatment (RR, 0.81; 95% CrI, 0.71-0.91) had higher rates than patients in the placebo group.
Conclusion: Administration of corticosteroids was associated with a reduced all-cause mortality at 28 days compared with placebo or usual care. Our analysis also confirmed the mortality benefit associated with low-dose and long-term treatment with corticosteroids.
Keywords: COVID-19; Corticosteroids; Dexamethasone; Indirect comparisons; Mortality; SARS-CoV-2.
. 2022 Oct 19;S1201-9712(22)00557-4.
doi: 10.1016/j.ijid.2022.10.021. Online ahead of print.
Effect of Corticosteroids in Patients with COVID-19: A Bayesian Network Meta-analysis: Corticosteroids in COVID-19
Xing Wang[SUP] 1 [/SUP], Dingke Wen[SUP] 1 [/SUP], Qiang He[SUP] 1 [/SUP], Jingguo Yang[SUP] 1 [/SUP], Chao You[SUP] 2 [/SUP], Chuanyuan Tao[SUP] 1 [/SUP], Lu Ma[SUP] 3 [/SUP]
Affiliations
- PMID: 36272700
- DOI: 10.1016/j.ijid.2022.10.021
Abstract
Objectives: We sought to perform a network meta-analysis to compare the safety and efficacy of the systemic administration for treating corticosteroids for coronavirus disease 2019 (COVID-19).
Methods: Bayesian network meta-analysis was performed to combine direct and indirect evidence. The surface under the cumulative ranking curve (SUCRA) was obtained to estimate the ranking probability of the treatment agents for each outcome. The efficacy outcome was 28-day all-cause mortality. The safety outcome was serious adverse events.
Results: A total of 16 trials with 2,992 patients comparing four treatments (dexamethasone, hydrocortisone, methylprednisolone, and placebo) were identified. Direct analysis showed that corticosteroids were associated with a reduced risk of 28-day mortality compared with usual care (RR, 0.83; 95% CI, 0.70-0.99). Network analysis showed that the pooled RR was 0.63 (95% CrI, 0.39-0.93) for all-cause mortality at 28 days when comparing methylprednisolone with usual care or placebo (SUCRA: 91%). Our analysis demonstrated that patients who received low dose of corticosteroids (RR, 0.80; 95% CrI, 0.70-0.91) and long course of treatment (RR, 0.81; 95% CrI, 0.71-0.91) had higher rates than patients in the placebo group.
Conclusion: Administration of corticosteroids was associated with a reduced all-cause mortality at 28 days compared with placebo or usual care. Our analysis also confirmed the mortality benefit associated with low-dose and long-term treatment with corticosteroids.
Keywords: COVID-19; Corticosteroids; Dexamethasone; Indirect comparisons; Mortality; SARS-CoV-2.