Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials
# Background More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management of severe COVID-19 and post-acute COVID-19 symptoms. This study synthesizes current evidence of the effectiveness of...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2023-08-01
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| Series: | Canadian Journal of Respiratory Therapy |
| Online Access: | https://doi.org/10.29390/001c.84260 |
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| author | Yasra Badi Mohamed Hammad Abdelrahman G. Tawfik Mona Muhe Eldeen Eshag Mahmoud M. Elhady Khaled Mohamed Ragab Anas Zakarya Nourelden Mohamed Hesham Gamal Ahmed Hashem Fathallah |
| author_facet | Yasra Badi Mohamed Hammad Abdelrahman G. Tawfik Mona Muhe Eldeen Eshag Mahmoud M. Elhady Khaled Mohamed Ragab Anas Zakarya Nourelden Mohamed Hesham Gamal Ahmed Hashem Fathallah |
| author_sort | Yasra Badi |
| collection | DOAJ |
| description | # Background
More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management of severe COVID-19 and post-acute COVID-19 symptoms. This study synthesizes current evidence of the effectiveness of inhaled corticosteroids (ICS) on mortality, hospital length-of-stay (LOS), and improvement of smell scores in patients with COVID-19.
# Methods
We searched Embase, Web of Science, PubMed, Cochrane Library, and Scopus until Aug 2022. The Cochrane risk of bias tool was used to assess the quality of studies. We evaluated the effectiveness of ICS in COVID-19 patients through measures of mortality, LOS, alleviation of post-acute COVID-19 symptoms, time to sustained self-reported cure, and sense of smell (visual analog scale (VAS)).
# Results
Ten studies were included in the meta-analysis. Our study showed a significant decrease in the LOS in ICS patients over placebo (MD = -1.52, 95% CI \[-2.77 to -0.28\], *p-value* = 0.02). Patients treated with intranasal corticosteroids (INC) showed a significant improvement in VAS smell scores from week three to week four (MD =1.52, 95% CI \[0.27 to 2.78\], *p-value* = 0.02), and alleviation of COVID-related symptoms after 14 days (RR = 1.17, 95% CI \[1.09 to 1.26\], *p-value* \< 0.0001). No significant differences were detected in mortality (RR= 0.69, 95% CI \[0.36 to 1.35\], *p-value* = 0.28) and time to sustained self-reported cure (MD = -1.28, 95% CI \[-6.77 to 4.20\], *p-value* = 0.65).
# Conclusion
We concluded that the use of ICS decreased patient LOS and improved COVID-19-related symptoms. INC may have a role in improving the smell score. Therefore, using INC and ICS for two weeks or more may prove beneficial. Current data do not demonstrate an effect on mortality or time to sustained self-reported cure. However, the evidence is inconclusive, and more studies are needed for more precise data. |
| format | Article |
| id | doaj-art-8462e2fce9554d02b35d4ccac810844c |
| institution | Kabale University |
| issn | 2368-6820 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj-art-8462e2fce9554d02b35d4ccac810844c2025-02-11T20:30:50ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202023-08-0159Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trialsYasra BadiMohamed HammadAbdelrahman G. TawfikMona Muhe Eldeen EshagMahmoud M. ElhadyKhaled Mohamed RagabAnas Zakarya NoureldenMohamed Hesham GamalAhmed Hashem Fathallah# Background More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management of severe COVID-19 and post-acute COVID-19 symptoms. This study synthesizes current evidence of the effectiveness of inhaled corticosteroids (ICS) on mortality, hospital length-of-stay (LOS), and improvement of smell scores in patients with COVID-19. # Methods We searched Embase, Web of Science, PubMed, Cochrane Library, and Scopus until Aug 2022. The Cochrane risk of bias tool was used to assess the quality of studies. We evaluated the effectiveness of ICS in COVID-19 patients through measures of mortality, LOS, alleviation of post-acute COVID-19 symptoms, time to sustained self-reported cure, and sense of smell (visual analog scale (VAS)). # Results Ten studies were included in the meta-analysis. Our study showed a significant decrease in the LOS in ICS patients over placebo (MD = -1.52, 95% CI \[-2.77 to -0.28\], *p-value* = 0.02). Patients treated with intranasal corticosteroids (INC) showed a significant improvement in VAS smell scores from week three to week four (MD =1.52, 95% CI \[0.27 to 2.78\], *p-value* = 0.02), and alleviation of COVID-related symptoms after 14 days (RR = 1.17, 95% CI \[1.09 to 1.26\], *p-value* \< 0.0001). No significant differences were detected in mortality (RR= 0.69, 95% CI \[0.36 to 1.35\], *p-value* = 0.28) and time to sustained self-reported cure (MD = -1.28, 95% CI \[-6.77 to 4.20\], *p-value* = 0.65). # Conclusion We concluded that the use of ICS decreased patient LOS and improved COVID-19-related symptoms. INC may have a role in improving the smell score. Therefore, using INC and ICS for two weeks or more may prove beneficial. Current data do not demonstrate an effect on mortality or time to sustained self-reported cure. However, the evidence is inconclusive, and more studies are needed for more precise data.https://doi.org/10.29390/001c.84260 |
| spellingShingle | Yasra Badi Mohamed Hammad Abdelrahman G. Tawfik Mona Muhe Eldeen Eshag Mahmoud M. Elhady Khaled Mohamed Ragab Anas Zakarya Nourelden Mohamed Hesham Gamal Ahmed Hashem Fathallah Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials Canadian Journal of Respiratory Therapy |
| title | Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | inhaled corticosteroids effect on covid 19 patients a systematic review and meta analysis of randomized controlled trials |
| url | https://doi.org/10.29390/001c.84260 |
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