Dosage and utilization of dexamethasone in the management of COVID-19: A critical review

作     者：Imran Sethi Asim Shaikh Musa Sethi Hira Khalid Chohan Sheraz Younus Syed A Khan Salim Surani 

作者机构：Department of Critical Care MedicineMarion General HospitalMarionIN 46952United States Department of MedicineAga Khan UniversityKarachi 74200SindhPakistan Department of MedicineEman SchoolFishersIN 46038United States Department of Internal MedicineDow University of Health ScienceKarachi 74200SindhPakistan Department of Hospital MedicineFranciscan HealthIndianapolisIN 46237United States Department of Critical Care MedicineMayo Clinic Health SystemMankatoMN 56001United States Department of Medicine and PharmacologyTexas A and M UniversityCollege StationTX 77843United States 

出 版 物：《World Journal of Virology》 (世界病毒学杂志)

年 卷 期：2024年第13卷第3期

页      面：107-114页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 Steroids Corticosteroids Steroid dosage Critical care Corona virus 

摘      要：BACKGROUND The severe respiratory manifestations observed in severe coronavirus disease 2019(COVID-19)cases are often associated with an excessive inflammatory ***,a synthetic glucocorticoid,exerts its anti-inflammatory effects by inhibiting the transcription of pro-inflammatory genes and suppressing the activity of various immune *** mechanism has implications for mitigating the cytokine storm observed in severe COVID-19 *** on in the pandemic,the Recovery Collaborative working group showed a mortality benefit of using dexamethasone in decreasing mortality in patients with COVID-19 requiring respiratory ***,the optimal dosage of corticosteroids remains *** studies that compare different doses of dexamethasone in COVID-19 exist,but the results are *** To review the latest evidence regarding dosage,safety,and efficacy of dexamethasone in severe *** We followed preferred reporting items for systematic reviews and meta-analysis guidelines.A detailed literature search was conducted across PubMed,Google Scholar,and Medline to include publications up to March *** keywords included“COVID-19“SARS-CoV-2“dexamethasone“corticosteroid“steroidand“glucocorticoid-along with their *** employed the Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale to evaluate the integrity and potential of bias in the included studies.A meta-analysis was conducted using a random-effects model,assessing pooled odds ratios and mean differences,with heterogeneity gauged by the I2 statistic and theχ^(2) *** No statistical differences were found in 28-day all-cause mortality[pooled odds ratio(OR)=1.109,95%CI:0.918-1.340],60-day all-cause mortality(OR=0.873,95%CI:0.744-1.024;I2=47.29%),mean length of hospital stay(mean difference=-0.08 days,95%CI:-0.001 to 0.161)and adverse events(OR=0.877,95%CI:0.707-1.087).CONCLUSION Differing doses of corticosteroids have no clinical implication