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Study Ref. Design studied treatmentcontrol treatmentpatientsstudy risk of biassample sizes Results

COVID 19 hospitalized meta-analysis

GLUCOCOVID
  2020-001934- 37		 RCTcorticosteroidsstandard of careCOVID 19 hospitalizedhigh
35/29 inconclusive
    RECOVERY dexamethasone
          NCT04381936    		 RCTdexamethasonestandard of careCOVID 19 hospitalizedsome concern
    		2104/4321 conclusif
    • demonstrated 17 % decrease in deaths (PE) with a moderate degree of certainty due to some concern in risk of bias
    • suggested 10 % increase in hospital discharge with a moderate degree of certainty due to some concern in risk of bias
    • suggested 23 % decrease in mechanical ventilation with a moderate degree of certainty due to some concern in risk of bias
    in an exploratory subgroup analysis there was no benefit among patients who did not require oxygen (1.22 [0.86 to 1.75]; p=0.14)

    COVID-19 severe or critically meta-analysis

    Jamaati
          IRCT20151227025726N1    		 RCTdexamethasonestandard of careCOVID-19 severe or criticallysome concern
    		25/25 suggested
    • inconclusive 19 % increase in deaths,death D28 (PE) with a moderate degree of certainty due to some concern in risk of bias
    • inconclusive 38 % increase in mechanical ventilation (PE) with a moderate degree of certainty due to some concern in risk of bias
    • suggested 3.9-fold increase in radiologic improvement (14-day) with a moderate degree of certainty due to some concern in risk of bias
    CODEX (Tomazini)
          NCT04327401    		 RCTdexamethasonestandard of careCOVID-19 severe or criticallysome concern
    		151/148 inconclusive
      DEXA-COVID19
              NCT04325061      		 RCTdexamethasonestandard of careCOVID-19 severe or criticallylow
      		7/12 inconclusive
        Edalatifard
                  IRCT20200404046947N1        		 RCTmethylprednisolonestandard of careCOVID-19 severe or criticallyhigh
        		34/34 suggested
        • suggested 71 % decrease in deaths,deaths (time to event analysis only) but with a low degree of certainty due to high risk of bias
        • suggested 11.0-fold increase in clinical improvement but with a low degree of certainty due to high risk of bias
        REMAP-CAP, fixed 7-day course
                  NCT02735707        		 RCTHydrocortisonestandard of careCOVID-19 severe or criticallyhigh
        		143/108 safety concern
        • inconclusive 43 % increase in clinical improvement (PE) but with a low degree of certainty due to high risk of bias
        • statistically significant 1.7-fold increase in death or ventilation but with a low degree of certainty due to high risk of bias
        REMAP-CAP, shock-dependent course
                  NCT02735707        		 RCTcorticosteroidsstandard of careCOVID-19 severe or criticallyhigh
        		152/108 inconclusive
        • inconclusive 22 % increase in clinical improvement (PE) but with a low degree of certainty due to high risk of bias
        Steroids-SARI
                  NCT04244591        		 RCTmethylprednisolonestandard of careCOVID-19 severe or criticallysome concern
        		24/23 inconclusive
          3 studies excluded by filtering options (0 RCT / 3 OBS)

          PE: primary endpoint; (a): to be demonstrated a result must be statistically significant on a primary endpoint (with multiplicity adjustment if necessary);
          Study risk of bias assessed for the study primary endpoint(s) or the main endpoints in case of no formally defined primary endpoint(s).

           

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