Related Experiment Video
Updated: Sep 22, 2025
Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19
Published on: May 25, 2022
Effectiveness of corticosteroids to treat coronavirus disease 2019 symptoms: A meta-analysis
Yiqian Zeng1, Weizhong Zeng1, Bihui Yang2
1Department of Critical Care Medicine, Zhuzhou Central Hospital, Zhuzhou, Hunan, China.
Insights
Corticosteroids reduce mortality in severe COVID-19 patients but not in non-severe cases. Low-dose dexamethasone over a longer duration benefits COVID-19 patients by lowering mortality.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pharmacology
Background:
- Corticosteroids are frequently used for coronavirus disease 2019 (COVID-19) symptoms, yet their efficacy remains debated.
- Assessing the precise therapeutic role of corticosteroids in COVID-19 patients is crucial for clinical decision-making.
Approach:
- A systematic review and meta-analysis of 9 randomized controlled trials (RCTs) involving 7907 patients was conducted.
- Primary endpoint: all-cause mortality. Secondary endpoint: length of hospital stay.
Key Points:
- Corticosteroid treatment significantly reduced all-cause mortality in COVID-19 patients (RR=0.88).
- Beneficial effects were observed in severe COVID-19 cases (RR=0.77), but not in non-severe cases (RR=0.96).
- Low-dose dexamethasone with a long treatment course demonstrated reduced all-cause mortality.
Conclusions:
- Corticosteroid therapy is associated with reduced mortality in severe COVID-19.
- In non-severe COVID-19, corticosteroids did not decrease mortality and may prolong hospital stays.
- Low-dose dexamethasone, administered over an extended period, can decrease mortality in COVID-19 patients.
Objective:
Currently, corticosteroids are widely used to treat coronavirus disease 2019 (COVID-19) symptoms. However, the therapeutic role of corticosteroids remains highly controversial. To that end, we aimed to assess the efficacy of corticosteroids in treating COVID-19 patients.
Method:
We searched PubMed, Embase, and Cochrane Library to select suitable studies. Our primary study endpoint was all-cause mortality. The secondary study endpoint was the length of hospital stay.
Results:
A total of 9 randomized controlled trials (RCTs) with 7907 patients were assessed. The pooled result indicated that corticosteroids treatment could significantly reduce all-cause mortality in patients with COVID-19 (RR=0.88, 95% CI [0.82, 0.95], P=0.002). When subgroup analyses were performed, we found that corticosteroids were associated with decreased all-cause mortality in severe COVID-19 patients (RR=0.77, 95% CI [0.68, 0.88], P<0.0001), however no obvious difference was observed in all-cause mortality of non-severe COVID-19 patients between the corticosteroid and control group (RR=0.96, 95% CI [0.86, 1.06], P=0.41), meanwhile, a low dose (RR=0.89, 95% CI [0.82, 0.97], P=0.007) of dexamethasone (RR=0.9, 95% CI [0.83, 0.98], P=0.01) with a long treatment course (RR=0.89, 95% CI [0.82, 0.98], P=0.02) was beneficial for all-cause mortality in COVID-19 patients. Additionally, we found that corticosteroids might be associated with a longer length of hospital stay in non-severe COVID-19 patients (MD=3.83, 95% CI [1.11, 6.56], P=0.006).
Conclusion:
Our results showed that corticosteroid therapy was related to a reduction in all-cause mortality in severe COVID-19 patients. However, in patients with non-severe COVID-19, the use of corticosteroids did not decrease all-cause mortality and may prolong the duration of hospital stay. In addition, we revealed that a low dose of dexamethasone with a long treatment course could reduce all-cause mortality in COVID-19 patients.
Related Concept Videos
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.