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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
    GLUCOCOVID
          2020-001934- 37    		 RCTcorticosteroidscontrolCOVID 19 hospitalizedhigh
    		35/29 inconclusive
    • inconclusive 32 % decrease in death or transfer to ICU (PE) but with a low degree of certainty due to high risk of bias
    Metcovid
          NCT04343729    		 RCTmethylprednisoloneplaceboCOVID 19 hospitalizedsome concern
    		209/207 inconclusive
    • inconclusive 8 % decrease in deaths,death D28 (PE) with a moderate degree of certainty due to some concern in risk of bias
    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)
    Tang X
          NCT04273321    		 RCTmethylprednisoloneplaceboCOVID 19 hospitalizedsome concern
    		43/43 suggested
    • inconclusive 0 % increase in clinical deterioration (PE) with a moderate degree of certainty due to some concern in risk of bias
    • suggested 78 % increase in viral clearance ,viral clearance (time to event analysis only) with a moderate degree of certainty due to some concern in risk of bias

    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
    Munch (COVID-STEROID)
          NCT04348305    		 RCTHydrocortisoneplaceboCOVID-19 severe or criticallylow
    		16/14 no results
      CAPE-COVID
              NCT02517489      		 RCTHydrocortisoneplaceboCOVID-19 severe or criticallylow
      		76/73 inconclusive
      • inconclusive 29 % decrease in death or ventilation (PE) with a high degree of certainty due to low 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
            4 studies excluded by filtering options (0 RCT / 4 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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