The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
Corticosteroids in COVID-19 and non-COVID-19 ARDS: a systematic review and meta-analysis
Open accessAbstract
Corticosteroids are now recommended for patients with severe COVID-19 including those with COVID-related ARDS. This has generated renewed interest regarding whether corticosteroids should be used in non-COVID ARDS as well. The objective of this study was to summarize all RCTs examining the use of corticosteroids in ARDS. The protocol of this study was pre-registered on PROSPERO (CRD42020200659). We searched online databases including MEDLINE, EMBASE, CDC library of COVID research, CINAHL, and COCHRANE. We included RCTs that compared the effect of corticosteroids to placebo or usual care in adult patients with ARDS, including patients with COVID-19. Three reviewers abstracted data independently and in duplicate using a pre-specified standardized form. We assessed individual study risk of bias using the revised Cochrane ROB-2 tool and rated certainty in outcomes using GRADE methodology. We pooled data using a random effects model. The main outcome for this review was 28-day-mortality. We included 18 RCTs enrolling 2826 patients. The use of corticosteroids probably reduced mortality in patients with ARDS of any etiology (2740 patients in 16 trials, RR 0.82, 95% CI 0.72–0.95, ARR 8.0%, 95% CI 2.2–12.5%, moderate certainty). Patients who received a longer course of corticosteroids (over 7 days) had higher rates of survival compared to a shorter course. The use of corticosteroids probably reduces mortality in patients with ARDS. This effect was consistent between patients with COVID-19 and non-COVID-19 ARDS, corticosteroid types, and dosage.
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Citations
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 1×
“We assessed certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach [14].”
MethodDexamethasone in Hospitalized Patients with Covid-19
The RECOVERY Collaborative Group (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2021436 · Cited by 11,477
Effect of Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report
Horby, P., Lim, W. S., Emberson, J., Mafham, M., Bell, J., Linsell, L., Staplin, N., Brightling, C., Ustianowski, A., Elmahi, E., et al. (2020) · doi:10.1101/2020.06.22.20137273 · Cited by 11,475
Chen, Y., Wang, L., Kang, Q., Zhang, X., Yu, G., Wan, X., Wang, J., & Zhu, K. (2017) · Cellular Physiology and Biochemistry · doi:10.1159/000477308 · Cited by 10,679
Acute Respiratory Distress Syndrome: The Berlin Definition
(2012) · JAMA · doi:10.1001/jama.2012.5669 · Cited by 8,731
Bernard, G. R., Artigas, A., Brigham, K. L., Carlet, J., Falke, K., Hudson, L., Lamy, M., Legall, J. R., Morris, A., & Spragg, R. (1994) · American journal of respiratory and critical care medicine · doi:10.1164/ajrccm.149.3.7509706 · Cited by 6,746 · cited 11×
“We included RCTs that compared corticosteroids to placebo or usual care in adult patients with ARDS (as defined by the American-European Consensus Conference (AECC) criteria [12] or the Berlin criteria for ARDS [13]).”
MethodResultInfluentialThe 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., et al. (2020) · JAMA · doi:10.1001/jama.2020.17023 · Cited by 2,257
Self-citationAcute respiratory distress syndrome
Thompson, B. T., Chambers, R. C., & Liu, K. D. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1608077 · Cited by 1,807
Efficacy and Safety of Corticosteroids for Persistent Acute Respiratory Distress Syndrome
(2006) · New England Journal of Medicine · doi:10.1056/nejmoa051693 · Cited by 1,498
The American Journal of Respiratory and Critical Care Medicine
Klocke, R. A., & Sylvester, J. T. (1994) · American Journal of Respiratory and Critical Care Medicine · Cited by 1,307
Cited by
Qadir, N., Sahetya, S., Munshi, L., Summers, C., Abrams, D., Beitler, J., Bellani, G., Brower, R. G., Burry, L., Chen, J.-T., et al. (2024) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202311-2011st · Cited by 444
Self-citationGorman, E. A., O’Kane, C. M., & McAuley, D. F. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01439-8 · Cited by 423
Evolution in the Diagnosis and Treatment of Myocarditis in Recent Years: State of the Art
Campodonico, J., Lauri, C., Pezzuto, B., Agostoni, P., & Vignati, C. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14217661 · Cited by 6
Metadata
- Authors
- Chaudhuri, D., Sasaki, K., Karkar, A., Sharif, S., Lewis, K., Mammen, M. J., Alexander, P., Ye, Z., Lozano, L. E. C., Munch, M. W., Perner, A., Du, B., Mbuagbaw, L., Alhazzani, W., Pastores, S. M., Marshall, J., Lamontagne, F., Annane, D., Meduri, G. U., & Rochwerg, B.
- Venue
- Intensive Care Medicine
- Published
- 2021-04-19
- Volume
- 47
- Issue
- 5
- Pages
- 521-537
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W3154855659
- Cited by
- 299
- References
- 36
- FWCI
- 12.49
- Type
- journal article
- Language
- en
- Open access
- bronze
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- The paper
- Chaudhuri, D., Sasaki, K., Karkar, A., Sharif, S., Lewis, K., Mammen, M. J., Alexander, P., Ye, Z., Lozano, L. E. C., Munch, M. W., Perner, A., Du, B., Mbuagbaw, L., Alhazzani, W., Pastores, S. M., Marshall, J., Lamontagne, F., Annane, D., Meduri, G. U., & Rochwerg, B. (2021). Corticosteroids in COVID-19 and non-COVID-19 ARDS: a systematic review and meta-analysis. Intensive Care Medicine. https://doi.org/10.1007/s00134-021-06394-2
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
