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Efficacy of Cortico...
Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis
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- Lee, Keum Hwa (författare)
- Yonsei Univ, South Korea
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- Yoon, Sojung (författare)
- Yonsei Univ, South Korea
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- Jeong, Gwang Hun (författare)
- Gyeongsang Natl Univ, South Korea
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- Kim, Jong Yeob (författare)
- Yonsei Univ, South Korea
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- Han, Young Joo (författare)
- Sungkyunkwan Univ, South Korea
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- Hong, Sung Hwi (författare)
- Harvard TH Chan Sch Publ Hlth, MA 02115 USA
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- Ryu, Seohyun (författare)
- Yonsei Univ, South Korea
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- Kim, Jae Seok (författare)
- Yonsei Univ, South Korea
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- Lee, Jun Young (författare)
- Yonsei Univ, South Korea
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- Yang, Jae Won (författare)
- Yonsei Univ, South Korea
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- Lee, Jinhee (författare)
- Yonsei Univ, South Korea
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- Solmi, Marco (författare)
- Univ Padua, Italy
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- Koyanagi, Ai (författare)
- CIBERSAM, Spain; ICREA, Spain
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- Dragioti, Elena (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum
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- Jacob, Louis (författare)
- CIBERSAM, Spain; Univ Versailles St Quentin En Yvelines, France
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- Radua, Joaquim (författare)
- Karolinska Institutet
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- Smith, Lee (författare)
- Anglia Ruskin Univ, England
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- Oh, Hans (författare)
- Univ Southern Calif, CA 90015 USA
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- Tizaoui, Kalthoum (författare)
- Tunis El Manar Univ, Tunisia
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- Cargnin, Sarah (författare)
- Univ Piemonte Orientale, Italy
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- Terrazzino, Salvatore (författare)
- Univ Piemonte Orientale, Italy; Univ Piemonte Orientale, Italy
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- Abou Ghayda, Ramy (författare)
- Harvard TH Chan Sch Publ Hlth, MA 02115 USA; Brigham & Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA
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- Kronbichler, Andreas (författare)
- Med Univ Innsbruck, Austria
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- Shin, Jae Il (författare)
- Yonsei Univ, South Korea
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(creator_code:org_t)
- 2020-07-27
- 2020
- Engelska.
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:8
- Relaterad länk:
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https://liu.diva-por... (primary) (Raw object)
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https://www.mdpi.com...
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https://urn.kb.se/re...
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https://doi.org/10.3...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- (1) Background: The use of corticosteroids in critical coronavirus infections, including severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome (MERS), or Coronavirus disease 2019 (COVID-19), has been controversial. However, a meta-analysis on the efficacy of steroids in treating these coronavirus infections is lacking. (2) Purpose: We assessed a methodological criticism on the quality of previous published meta-analyses and the risk of misleading conclusions with important therapeutic consequences. We also examined the evidence of the efficacy of corticosteroids in reducing mortality in SARS, MERS and COVID-19. (3) Methods: PubMed, MEDLINE, Embase, and Web of Science were used to identify studies published until 25 April 2020, that reported associations between steroid use and mortality in treating SARS/MERS/COVID-19. Two investigators screened and extracted data independently. Searches were restricted to studies on humans, and articles that did not report the exact number of patients in each group or data on mortality were excluded. We calculated odds ratios (ORs) or hazard ratios (HRs) under the fixed- and random-effect model. (4) Results: Eight articles (4051 patients) were eligible for inclusion. Among these selected studies, 3416 patients were diagnosed with SARS, 360 patients with MERS, and 275 with COVID-19; 60.3% patients were administered steroids. The meta-analyses including all studies showed no differences overall in terms of mortality (OR 1.152, 95% CI 0.631-2.101 in the random effects model,p= 0.645). However, this conclusion might be biased, because, in some studies, the patients in the steroid group had more severe symptoms than those in the control group. In contrast, when the meta-analysis was performed restricting only to studies that used appropriate adjustment (e.g., time, disease severity), there was a significant difference between the two groups (HR 0.378, 95% CI 0.221-0.646 in the random effects model,p< 0.0001). Although there was no difference in mortality when steroids were used in severe cases, there was a difference among the group with more underlying diseases (OR 3.133, 95% CI 1.670-5.877,p< 0.001). (5) Conclusions: To our knowledge, this study is the first comprehensive systematic review and meta-analysis providing the most accurate evidence on the effect of steroids in coronavirus infections. If not contraindicated, and in the absence of side effects, the use of steroids should be considered in coronavirus infection including COVID-19.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- corticosteroids; coronavirus; severe acute respiratory syndrome (SARS); Middle East respiratory syndrome (MERS); coronavirus disease 2019 (COVID-19)
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Lee, Keum Hwa
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Yoon, Sojung
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Jeong, Gwang Hun
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Kim, Jong Yeob
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Han, Young Joo
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Hong, Sung Hwi
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Ryu, Seohyun
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Kim, Jae Seok
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Lee, Jun Young
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Yang, Jae Won
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Lee, Jinhee
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Solmi, Marco
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Koyanagi, Ai
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Dragioti, Elena
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Jacob, Louis
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Radua, Joaquim
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Smith, Lee
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Oh, Hans
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Tizaoui, Kalthou ...
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Cargnin, Sarah
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Terrazzino, Salv ...
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Abou Ghayda, Ram ...
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Kronbichler, And ...
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Shin, Jae Il
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Journal of Clini ...
- Av lärosätet
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Linköpings universitet
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Karolinska Institutet