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Cited by 2,257COVID-19 Clinical Research StudiesRespiratory Support and MechanismsAdrenal Hormones and Disorders

Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis

Open access
The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne, Jonathan A. C., Murthy, Srinivas, Diaz, Janet V., Slutsky, Arthur S., Villar, Jesús, Angus, Derek C., Annane, Djillali +31 more·2020·JAMA
DOI 10.1001/jama.2020.17023PMC PMC7489434
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Abstract

Importance: Effective therapies for patients with coronavirus disease 2019 (COVID-19) are needed, and clinical trial data have demonstrated that low-dose dexamethasone reduced mortality in hospitalized patients with COVID-19 who required respiratory support. Objective: To estimate the association between administration of corticosteroids compared with usual care or placebo and 28-day all-cause mortality. Design, Setting, and Participants: Prospective meta-analysis that pooled data from 7 randomized clinical trials that evaluated the efficacy of corticosteroids in 1703 critically ill patients with COVID-19. The trials were conducted in 12 countries from February 26, 2020, to June 9, 2020, and the date of final follow-up was July 6, 2020. Pooled data were aggregated from the individual trials, overall, and in predefined subgroups. Risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I2 statistic. The primary analysis was an inverse variance-weighted fixed-effect meta-analysis of overall mortality, with the association between the intervention and mortality quantified using odds ratios (ORs). Random-effects meta-analyses also were conducted (with the Paule-Mandel estimate of heterogeneity and the Hartung-Knapp adjustment) and an inverse variance-weighted fixed-effect analysis using risk ratios. Exposures: Patients had been randomized to receive systemic dexamethasone, hydrocortisone, or methylprednisolone (678 patients) or to receive usual care or placebo (1025 patients). Main Outcomes and Measures: The primary outcome measure was all-cause mortality at 28 days after randomization. A secondary outcome was investigator-defined serious adverse events. Results: A total of 1703 patients (median age, 60 years [interquartile range, 52-68 years]; 488 [29%] women) were included in the analysis. Risk of bias was assessed as "low" for 6 of the 7 mortality results and as "some concerns" in 1 trial because of the randomization method. Five trials reported mortality at 28 days, 1 trial at 21 days, and 1 trial at 30 days. There were 222 deaths among the 678 patients randomized to corticosteroids and 425 deaths among the 1025 patients randomized to usual care or placebo (summary OR, 0.66 [95% CI, 0.53-0.82]; P < .001 based on a fixed-effect meta-analysis). There was little inconsistency between the trial results (I2 = 15.6%; P = .31 for heterogeneity) and the summary OR was 0.70 (95% CI, 0.48-1.01; P = .053) based on the random-effects meta-analysis. The fixed-effect summary OR for the association with mortality was 0.64 (95% CI, 0.50-0.82; P < .001) for dexamethasone compared with usual care or placebo (3 trials, 1282 patients, and 527 deaths), the OR was 0.69 (95% CI, 0.43-1.12; P = .13) for hydrocortisone (3 trials, 374 patients, and 94 deaths), and the OR was 0.91 (95% CI, 0.29-2.87; P = .87) for methylprednisolone (1 trial, 47 patients, and 26 deaths). Among the 6 trials that reported serious adverse events, 64 events occurred among 354 patients randomized to corticosteroids and 80 events occurred among 342 patients randomized to usual care or placebo. Conclusions and Relevance: In this prospective meta-analysis of clinical trials of critically ill patients with COVID-19, administration of systemic corticosteroids, compared with usual care or placebo, was associated with lower 28-day all-cause mortality.

Integrity signals

Registry

Crossref · 10.1001/jama.2020.17023

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 8 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Deaths numbered 222 among 678 corticosteroid-assigned patients and 425 among 1025 assigned to usual care or placebo.

    “There were 222 deaths among 678 patients randomized to corticosteroids and 425 deaths among 1025 patients randomized to usual care or placebo.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among patients symptomatic for more than 7 days before randomization, corticosteroids were associated with lower mortality (OR 0.64, 95% CI 0.49-0.83).

    “the OR was 0.64 (95% CI, 0.49-0.83) among 1111 patients who were sympto- matic for more than 7 days prior to randomization”
    Quote in the paperSubstantial claim
  • Findingown data

    In patients receiving vasoactive agents at randomization, corticosteroids were not associated with lower mortality (OR 1.05, 95% CI 0.65-1.69; absolute risk 48% vs 47%).

    “For the association be- tween corticosteroids and mortality, the OR was 1.05 (95% CI, 0.65-1.69) among patients who were receiving vasoactive agents at randomization (an absolute risk of 48% for cortico- steroids vs 47% for usual care or placebo)”
    Quote in the paperSubstantial claim
  • Findingown data

    In patients not receiving vasoactive agents at randomization, corticosteroids were associated with lower mortality (OR 0.55, 95% CI 0.34-0.88; absolute risk 24% vs 37%).

    “the OR was 0.55 (95% CI, 0.34-0.88) among patients who were not receiving vasoactive agents at randomization (an absolute risk of 24% for corticosteroids vs 37% for usual care or placebo).”
    Quote in the paperSubstantial claim
  • Findingown data

    Among patients receiving vasoactive medication, the odds ratio for corticosteroids versus usual care or placebo and death was 1.05 (95% CI 0.65-1.69).

    “49.8 76/169 74/158 Yes (I 2 = 0%) 1.05 (0.65-1.69)”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 27
  • May combine two claims. 16

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Concurrent antiviral or azithromycin treatment varied substantially across trials.

    “The extent of concurrent treatment with antiviral agents or azithromycin varied substantially among the trials (Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The analysis included 1703 randomized patients (678 corticosteroids, 1025 usual care or placebo), median age 60 years, and 488 women (29%).

    “A total of 1703 patients were randomized (678 to corticosteroids and 1025 to usual care or placebo) in the 7 trials, the median age was 60 years (interquartile range, 52-68 years), and 488 patients (29%) were women (Table 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Mortality was reported at 28 days in five trials, at 21 days in one, and at 30 days in one.

    “Five trials reported mortality at 28 days, 1 trial at 21 days, and 1 trial at 30 days.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The larger usual care or placebo group resulted from RECOVERY's 1:2 randomization, which contributed 1007 patients (59.1%) to this analysis.

    “The larger number of patients randomized to usual care or placebo was due to randomization in the RECOVERY trial (contributed 1007 [59.1%] patients to this analysis) in which patients were assigned to corticosteroid or usual care in a ratio of 1:2.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In every trial, most patients were male.

    “In all trials, the majority of patients were male.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The proportion of patients with polymerase-chain-reaction-confirmed SARS-CoV-2 infection ranged from 78.7% to 100% across trials.

    “the proportions of patients with SARS-CoV-2 infection confirmed by polymerase chain reaction ranged from 78.7% to 100% across trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Among 695 patients from six trials with available data, 327 (47.0%) were receiving vasoactive agents for blood pressure support at randomization.

    “Among 695 patients from 6 trials for whom data were avail- able, 327 (47.0%) were receiving vasoactive agents for blood pressure support at randomization.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The ORs for the association between corticosteroids and mortality appeared similar for older and younger individuals, men and women, and longer and shorter durations of symptoms before randomization.

    “The ORs for the association between corticosteroids and mortality appeared similar for older and younger individuals, men and women, and for longer and shorter durations of symptoms before randomization.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The Steroids-SARI trial accounted for 3.5% of the weight in the primary meta-analysis.

    “The trial for which the risk of bias was assessed as “some concerns” (Steroids-SARI; NCT04244591) was relatively small (47 patients and 26 deaths) and contributed only 3.5% of the weight in the primary meta-analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The included trials were mainly conducted in high-income settings.

    “the trials were mainly conducted in high-income settings”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The Steroids-SARI trial was relatively small, with 47 patients and 26 deaths.

    “The trial for which the risk of bias was assessed as “some concerns” (Steroids-SARI; NCT04244591) was relatively small (47 patients and 26 deaths) and contributed only 3.5% of the weight in the primary meta-analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Serious adverse events varied across trials, but there was no suggestion that risk was higher with corticosteroids except in the two smallest trials, where total serious adverse events were 1 and 3.

    “Adverse events varied across trials but there was no suggestion that the risk of serious adverse events was higher in patients assigned to corticosteroids except for the 2 smallest trials, in which the total number of serious adverse events was 1 and 3.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Inclusion of data from the Metcovid trial did not materially change the results other than reducing inconsistency among trials.

    “Inclusion of data from the Metcovid trial did not materially change the results other than reducing the inconsistency among the trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All trials contributed data according to age group and sex.

    “All trials contributed data according to age group and sex.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    All trials had institutional review board approval and obtained informed consent consistent with local requirements.

    “All trials secured institutional review board approval, but approval was not required for the secondary data analysis reported here.Informed consent for participation in each trial was obtained and was consistent with local institutional review board requirements.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Comparisons between trial-characteristic subgroups used random-effects meta-regression and were interpreted as exploratory due to few trials and possible confounding.

    “Comparisons between subgroups defined by trial characteristics were made using randomeffects meta-regression and interpreted as exploratory because of the small number of trials and the potential for confounding by other characteristics.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    All subgroup analyses except the symptomatic-duration subgroup were prespecified before outcome data were available.

    “The fifth subgroup was specified post hoc based on results from the RECOVERY trial.All other subgroup analyses were prespecified before any outcome data became available.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    A meta-analysis of serious adverse events was not performed because their definitions differed across trials.

    “Because the definitions of serious adverse events varied among the trials, a meta-analysis of this outcome was not conducted.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Risk-of-bias assessments were performed independently by four investigators, with disagreements resolved by discussion.

    “Risk of bias assessments were done independently by 4 of the investigators (A.G., J.P.T.H., M.H.M., and J.S.), with disagreements resolved through discussion.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The primary analysis was prespecified as an inverse variance-weighted fixed-effect meta-analysis of odds ratios for overall mortality.

    “The primary analysis was an inverse variance-weighted fixed-effect meta-analysis of odds ratios (ORs) for overall mortality”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Missing outcome data were minimal, and follow-up for mortality and serious adverse events was complete in four of seven trials.

    “There were minimal missing outcome data.Follow-up was complete for both mortality and serious adverse events for 4 of the 7 trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The Steroids-SARI trial recorded adverse events but did not categorize them as serious or nonserious.

    “The Steroids-SARI trial (NCT04244591) recorded adverse events but did not categorize them as serious or nonserious adverse events.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Data were pooled through June 9, 2020, because management after that date was likely influenced by the RECOVERY results released on June 16, 2020.

    “Data were pooled from patients recruited to the participating trials through June 9, 2020, because patient management after that date was likely to be affected by the release of results of the RECOVERY trial on June 16, 2020.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Patient management after June 9, 2020 was likely affected by the release of the RECOVERY trial results.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The meta-analysis protocol was registered on PROSPERO (CRD42020197242) on July 6, 2020.

    “The protocol was registered and made publicly avail-able on the PROSPERO database (CRD42020197242) on July 6, 2020”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The control-group dexamethasone use in RECOVERY was considered usual practice and not a source of bias in the assignment effect.

    “This was regarded as reflecting usual practice, 22 and was not considered to introduce a risk of bias in the effect of assignment to the intervention.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The optimal dose and duration of treatment could not be assessed in this analysis.

    “The optimal dose and duration of treatment could not be assessed in this analysis”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The protocol and analysis plan, including specification of subgroup analyses, was registered and made publicly available on PROSPERO prior to data analysis or receipt of outcome data.

    “The protocol and analysis plan, including specification of subgroup analyses, was registered and made publicly available on the PROSPERO database prior to data analysis or receipt of outcome data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    There were only limited missing outcome data.

    “Third, there were only limited missing outcome data”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Data from the Metcovid trial were not included in the primary meta-analysis because the trial was registered after the searches of the trial registries were conducted.

    “Data from the Metcovid trial were not included in the primary meta-analysis because this trial was registered after the searches of the trial registries were conducted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Follow-up ended at hospital discharge in many of the trials.

    “in many trials, follow-up was censored when participants were discharged from the hospital.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The other four trials had unblinded outcome assessment and were assessed as having some concerns for risk of bias because classification of serious adverse events could differ between groups.

    “The other 4 trials had unblinded outcome assessment, and the risk of bias was assessed as “some concerns” based on subjectivity implying that classification of serious adverse events could differ between intervention groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All subgroup analyses other than the comparison of longer versus shorter duration of symptoms at randomization were prespecified.

    “All subgroup analyses other than that comparing longer with shorter duration of symptoms at randomization were prespecified.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    As is standard in meta-analyses, patients were compared only with other patients randomized in the same trial.

    “As is standard in meta-analyses, patients were compared only with other patients randomized in the same trial.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    This prospective meta-analysis was based on a relatively large number of critically ill COVID-19 patients from geographically diverse sites randomized to corticosteroids or usual care or placebo.

    “This prospective meta-analysis was based on a relatively large number of critically ill patients with COVID-19 from geographically diverse sites who were randomized to receive corticosteroids or to receive usual care or placebo.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The number of randomized patients in eligible trials who did not take part is probably less than the total number of patients analyzed here.

    “Nonetheless, the number of patients randomized in eligible trials who did not participate is likely to be smaller than the number of patients included in this meta-analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The substantial risk of death in these patients (682/2604 [26.1%] in the control group) is consistent with mortality in critically ill patients with COVID-19.

    “Nonetheless, the substantial risk of death in these patients (682/2604 [26.1%] in the control group) is consistent with mortality in critically ill patients with COVID-19.24,25”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] source

      Not checked in the free run.

    • cites [25] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The protocol has been published along with a structured abstract.

    “The protocol also has been published along with a structured abstract.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8]

      Not checked in the free run.

37 of 37

  • The authors state this as an assumption.

    For illustrative absolute risk estimates, the mortality risk without corticosteroids was assumed to be 40%.

    “we assumed a mortality risk without corticosteroids of 40% (approximately, the risk among all patients allocated to usual care or placebo)”

  • The authors state this as an assumption.

    For subgroup absolute risk estimates, the mortality risk without corticosteroids was assumed to equal the observed risk among patients in that subgroup randomized to usual care or placebo.

    “we assumed a mortality risk equal to the observed risk across patients in that subgroup who were randomized to usual care or placebo”

  • The paper relies on this without support.

    Patient management after June 9, 2020 was likely affected by the release of the RECOVERY trial results.

    “because patient management after that date was likely to be affected by the release of results of the RECOVERY trial on June 16, 2020”

  • The paper relies on this without support.

    The effect of corticosteroids on 28-day mortality after discharge does not differ from the effect before discharge.

    “We are aware of no reason that the effect of corticosteroids on postdischarge 28-day mortality would differ from that on predischarge mortality”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Nonventilated control-group risk uses the wrong percentage

    Minor

    The figure gives 28 deaths among 74 nonventilated control patients, an observed risk of 37.8%, not 42%. The stated 38% and 42% control risks appear to have been exchanged between the ventilation subgroups.

    Reported 42 · recomputed 37.837838

  • Ventilated patient count is 100 too low

    Minor

    The subgroup figure lists 608 corticosteroid patients and 951 control patients receiving invasive mechanical ventilation, totaling 1559 rather than 1459.

    Reported 1459 · recomputed 1559

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Sterne, Corticosteroid therapy for critically ill patients with COVID-19., Trials
  2. Langan, 2017, Comparative performance of heterogeneity variance estimators in meta-analysis., Res Synth Methods, 8, 181, 10.1002/jrsm.v8.2 · DOI
  3. Jeronimo, Methylprednisolone as adjunctive therapy for patients hospitalized with COVID-19 (Metcovid)., Clin Infect Dis

Cited by

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Related

Authors
The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne, J. A. C., Murthy, S., Diaz, J. V., Slutsky, A. S., Villar, J., Angus, D. C., Annane, D., Azevedo, L. C. P., Berwanger, O., Cavalcanti, A. B., Dequin, P.-F., Du, B., Emberson, J., Fisher, D., Giraudeau, B., Gordon, A. C., Granholm, A., Green, C., Haynes, R., Heming, N., Higgins, J. P. T., Horby, P., Jüni, P., Landray, M. J., Le Gouge, A., Leclerc, M., Lim, W. S., Machado, F. R., McArthur, C., Meziani, F., Møller, M. H., Perner, A., Petersen, M. W., Savovic, J., Tomazini, B., Veiga, V. C., Webb, S., & Marshall, J. C.
Affiliations
  • University of Bristol (GB)
  • University of British Columbia (CA)
  • St. Michael's Hospital (CA)
  • University of Pittsburgh (US)
  • Universidade de São Paulo (BR)
  • Hospital Sírio-Libanês, São Paulo, Brazil
  • Hospital Israelita Albert Einstein (BR)
  • Université de Tours (FR)
  • Médecine Intensive-Réanimation, INSERM CIC1415, CHRU de Tours, Tours, France
  • Peking Union Medical College Hospital (CN)
  • University of Oxford (GB)
  • Inserm (FR)
  • University of Copenhagen (DK)
  • Université de Versailles Saint-Quentin-en-Yvelines (FR)
  • CIC INSERM 1415-CHRU de Tours, Tours, France
  • Nottingham University Hospitals NHS Trust (GB)
  • Anesthesiology, Pain, and Intensive Care Department, Federal University of São Paulo, São Paulo, Brazil
  • Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
  • St John of God Subiaco Hospital (AU)
Corresponding author
Sterne, Jonathan A. C.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2020-10-06
Volume
324
Issue
13
Pages
1330
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2020.17023
PMC
PMC7489434
OpenAlex
W3082355253
Semantic Scholar
c40537695ad1c573a608449e4ff9bb6bc94c3dab
Cited by
2,257
References
30
Citations by year
2026: 39 · 2025: 92 · 2024: 175 · 2023: 302 · 2022: 538 · 2021: 906 · 2020: 204
FWCI
63.88
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (acceptedVersion, other-oa)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • HAL (submittedVersion)
Funders
  • Amgen
  • Pfizer
  • AstraZeneca
  • World Health Organization
  • Nottingham University Hospitals NHS Trust
  • University Hospitals Bristol NHS Foundation Trust
  • UK Research and Innovation
  • Medicines Company
  • National Institute for Health and Care Research (11/46/14, NF-SI-0616-10111, COVID-19, NF-SI-0617-10145, RP-2015-06-018)
  • University of Oxford
  • University of Nottingham
  • Institut National de la Santé et de la Recherche Médicale
  • Monash University
  • University of Toronto
  • Novo Nordisk
  • Rigshospitalet
  • Universidade de São Paulo
  • Oxford University Hospitals NHS Foundation Trust
  • Novo Nordisk Fonden (NNF20SA0062998)
  • Universidade do Estado do Amazonas
  • Minderoo Foundation
  • Abbott Vascular
  • Canadian Institutes of Health Research
  • Medical Research Council (MC_UU_12023/22, MC_UU_12023/21, MC_UU_00017/3, MC_PC_20062)
  • National Health and Medical Research Council
  • Health Research Council of New Zealand
  • NIHR Oxford Biomedical Research Centre
  • Health Data Research UK
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
COVID-19 pandemic, systemic corticosteroids, dexamethasone, cortisol, methylprednisolone, 28-day mortality, critically ill patients, serious adverse events, corticosteroid therapy, risk of bias, subgroup analysis, risk of bias assessment
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Adrenal Cortex Hormones, Cause of Death, Dexamethasone, Glucocorticoids, Humans, Hydrocortisone, Methylprednisolone, Pneumonia, Viral, Randomized Controlled Trials as Topic, Critical Illness, Coronavirus Infections, Pandemics

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