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

World Journal of Virology 2024年第3期13卷 107-114页

作者： Imran Sethi Asim Shaikh Musa Sethi hira k.alid chohan Sheraz Younus Syed A khan Salim Surani Department of Critical Care Medicine Marion General HospitalMarionIN 46952United States Department of Medicine Aga Khan UniversityKarachi 74200SindhPakistan Department of Medicine Eman SchoolFishersIN 46038United States Department of Internal Medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of Hospital Medicine Franciscan HealthIndianapolisIN 46237United States Department of Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States

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”“steroid”and“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

关键词： COVID-19 Steroids Corticosteroids Steroid dosage Critical care Corona virus

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