Evidence and Hope During the Pandemic

Encouraging results were published today, September 2, in JAMA reporting on the reduction in 28-day mortality associated with steroid administration in critically ill COVID-19 patients. The authors reported on their prospective meta-analysis of 7 randomized trials, with a total of 1703 patients, who were randomized to either corticosteroids or placebo (or usual care). There were 222 deaths among the 678 patients randomized to corticosteroids versus 425 deaths among the 1025 patients randomized to usual care or placebo (summary OR, 0.66 [95% CI, 0.53-0.82]. Notably, the associated editorial was entitled “Corticosteroids in COVID-19 ARDS: Evidence and Hope During the Pandemic”

Following the online JAMA publication, the World Health Organization updated its guidance around the recommendation for the use of steroids in COVID-19 patients. “We recommend systemic corticosteroids for the treatment of patients with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful.”