Veronese Nicola, Demurtas Jacopo, Yang Lin, Tonelli Roberto, Barbagallo Mario, Lopalco Pierluigi, Lagolio Erik, Celotto Stefano, Pizzol Damiano, Zou Liye, Tully Mark A, Ilie Petre Cristian, Trott Mike, López-Sánchez Guillermo F, Smith Lee
Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
Front Med (Lausanne). 2020 Apr 24;7:170. doi: 10.3389/fmed.2020.00170. eCollection 2020.
The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. However, one study, on 201 participants with different stages of pneumonia due to COVID-19, found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%. The literature to date does not fully support the routine use of corticosteroids in COVID-19, but some findings suggest that methylprednisolone could lower mortality rate in more severe forms of the condition.
目的是研究糖皮质激素疗法对新型冠状病毒肺炎(COVID-19)患者的有效性。按照PRISMA指南,从数据库创建至2020年3月15日对九个数据库进行了系统的文献检索。纳入确诊为COVID-19且使用皮质类固醇的患者,并考虑所有健康结局。纳入了四项研究,共542名中国参与者。两项研究报告了关于COVID-19患者使用皮质类固醇的阴性结果,即皮质类固醇对临床结局有不利影响。一项研究报告使用皮质类固醇与临床结局之间无显著关联。然而,一项针对201名处于COVID-19所致不同肺炎阶段的参与者的研究发现,在病情更严重的情况下,给予甲泼尼龙可使死亡风险显著降低62%。迄今为止的文献并不完全支持在COVID-19中常规使用皮质类固醇,但一些研究结果表明甲泼尼龙可降低病情更严重情况下的死亡率。