Meta-analysis finds link between corticosteroids, improved mortality in COVID-19 patients

Editor's Note

This prospective meta-analysis from the World Health Organization (WHO) Rapid Evidence Appraisal for COVID-19 Therapies, which pooled data from seven randomized clinical trials of critically ill patients with COVID-19, finds that administration of systemic corticosteroids, compared with usual care or placebo, was associated with lower 28-day all-cause mortality.

A total of 1,703 patients were included in the analysis. There were 222 deaths among the 678 patients randomized to corticosteroids and 425 deaths among the 1,025 patients randomized to usual care or placebo. This corresponds to an absolute mortality risk of 32% with corticosteroids compared to 40% with usual care or placebo.

As a result of this meta-analysis, WHO is updating its COVID-19 treatment guidance to include corticosteroids.

An accompanying editorial from Vanderbilt University, Nashville, Tennessee, (https://jamanetwork.com/journals/jama/fullarticle/2770275) notes that the studies provide evidence and hope that an effective, inexpensive, and safe treatment has been identified and also hope from the high level of coordination and data sharing facilitated by WHO.