Table 1 Details of included studies
Author Year Country | Sample size | Intervention: Control | Inclusion criteria | Regimen of Corticosteroid | Control intervention | Planned primary Outcome | Time Course | |
Edalatifard 2020 [34] Iran | 62 | 34:28 | Confirmed COVID-19 with SpO2 < 90%, elevated CRP and IL-6 without ventilator and intubation | Methylprednisolone (IV) 250 mg/d for 3 days | Standard care | The time of clinical improvement or death | 20 April 2020–20 June 2020 | |
Corral-gudino 2021 [35] Spain | 64 | 35:29 | Adult COVID-19 patients, Symptom duration > 7 days, with evidence of systemic inflammatory response | Methylprednisolone (IV) 40 mg bid for 3 days followed by 20 mg BID for 3 days | Standard care | Composite of death, ICU admission, requirement for NIMV. | April 2020–June 2020 | |
Tang 2021 [31] China | 86 | 43:43 | Adult patients with COVID-19 pneumonia who were admitted to the general ward | Methylprednisolone (IV) 1 mg/kg/day for 7 days | Placebo | Clinical deterioration in 14 days | 19 February 2020–31 March 2020 | |
Ranjbar 2021 [22] Iran | 93 | 47:46 | Hospitalized adult patients, with SpO2 < 92 in room air. | Methylprednisolone (IV) 2 mg/kg/day | Dexamethasone (IV) 6 mg/kg/day | All-cause mortality at 28 days, clinical status at day 5, 10. | August 2020-November 2020 | |
Jeronimo 2021 [25] Brazil | 416 | 209:207 | Hospitalized adult patients either had SpO2 ≤ 94% with room air, or required IMV | Methylprednisolone (IV) 0.5 mg/kg BID for 5 days | Placebo | 28-day mortality | 18 April 2020–16 June 2020 | |
Dequin 2020 [24] France | 149 | 76:73 | Confirmed or suspected COVID-19 with acute respiratory failure | Hydrocortisone (IV) 200 mg/d until day 7, then 100 mg/d for 4 days and 50 mg/d for 3 days | Placebo | Treatment failure on day 21 | 7 March 2020–1 June 2020 | |
Angus 2020 [37] International | 379 | 283:101 | Adult patients with suspected or confirmed COVID-19 | Hydrocortisone (IV) 50 mg QID for 7 days; while in shock for up to 28 days; | Standard care | Organ support–free days within 21 days | 9 March 2020–17 June 2020 | |
Munch 2021 [23] Denmark | 30 | 16:14 | Hospitalized adult patients with confirmed SARS-CoV-2 infection and severe hypoxia | Hydrocortisone (IV) 200 mg/day for 7 days | Placebo | Days alive without life support | 15 April 2020–3 September 2020 | |
Jamaati 2021 [29] Iran | 50 | 25:25 | Adult patients with COVID-19 pneumonia, PaO2/FiO2 between 100 and 300 | Dexamethasone (IV) 20 mg/day from day 1–5, then 10 mg/day until day 10 | Standard Care | Need for IMV and death rate. | March 2020- | |
Tomazini 2021 [13] Brazil | 299 | 151:148 | Adult patients had confirmed or suspected COVID-19, receiving mechanical ventilation within 48 h | Dexamethasone (IV) 20 mg/day for 5 days, followed by 10 mg/day for additional 5 days or until ICU discharge | Standard care | Ventilator-free days during the first 28 days | 17 April 2020–23 June 2020 | |
Munch 2021 [30] Europe, India | 1000 | 503:497 | Hospitalized adult COVID-19 patients, required supplementary oxygen > 10 L/min, NIMV, CPAP or IMV | Dexamethasone (IV) 12 mg/day for 10 days | Dexamethasone (IV) 6 mg/ day for 10 days | Days alive without life support at 28 days | 27 August 2020–20 May 2021 | |
Horby 2021 [12] United Kingdom | 6425 | 2104:4321 | Adult patients who were hospitalized with COVID-19 | Dexamethasone (Oral/IV) 6 mg/day for 10 days | Standard care | 28-day mortality | 19 March 2020–8 June 2020 | |
Maskin 2022 [33] Argentina | 100 | 49:51 | Adult patients with confirmed COVID-19-related ARDS | Dexamethasone (IV) 16 mg/day for 5 days, then 8 mg/day for 5 days | Dexamethasone (IV) 6 mg/day for 10 days | Ventilator-free days during 28 days | 17 June 2020–27 March 2021 | |
Bouadma 2022 [36] France | 546 | 270:276 | Adults with AHRF admitted to ICU for confirmed or suspected COVID-19 | Dexamethasone (IV) 20 mg/day on days 1–5 then 10 mg/d on days 6–10 | Dexamethasone (IV) 6 mg/day for 10 days | all-cause mortality, assessed at day 60 | 10 April 10–17 September 2020 | |
Taboada 2021 [32] Spain | 200 | 98:102 | Adult patients with confirmed COVID-19, receiving supplemental oxygen | Dexamethasone (IV) 20 mg/day for 5 days, followed by 10 mg/day for 5 days | Dexamethasone (IV) 6 mg/day for 10 days | Clinical worsening within 11 days | 15 January 2021–26 May 2021 | |
Dastenae 2022 [28] Iran | 143 | 73:70 | All patients with COVID-19 who tested positive by RT-PCR test | Methylprednisolone (IV) 60 mg/day in two divided doses | Dexamethasone (IV) 8 mg/day | Duration of hospitalization | April 2021-June 2021 | |
Salvarani 2022 [27] Italy | 304 | 152:152 | Adult patients with COVID-19 infection, requiring supplemental oxygen | Methylprednisolone (IV) 1 g/day for 3 days | Dexamethasone (IV) 6 mg/day for 10 days | Duration of hospitalization | 21 December 2020–10 March 2021 | |
Wu 2022 [26] United State | 110 | 55:55 | Adult patients with PCR-confirmed COVID-19, needing supplemental oxygen | Dexamethasone (IV) 20 mg/day for 5 days, then 10 mg/day for 5 days | Dexamethasone (IV) 6 mg/day for 10 days | Clinical improvement at day 28 | January 2021- December 2021 | |
Author Year Country | Sample size | Intervention: Control | Inclusion criteria | Regimen of Corticosteroid | Planned primary Outcome | Time course | ||
Toroghi 2021 [21] Iran | 144 | 48:48:48 | Hospitalized adult COVID-19 patients, required supplementary oxygen | Dexamethasone(IV) 8 mg TID for 10 days | Dexamethasone(IV) 8 mg BID for 10 days | Dexamethasone(IV) 8 mg/day for 10 days | Clinical response | 26 October 2020–25 January 2021 |