Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.

0 CRITICAL CARE MEDICINE

Canadian Journal of Respiratory Therapy Pub Date : 2023-08-01 eCollection Date: 2023-01-01 DOI:10.29390/001c.84260

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

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引用次数: 0

Abstract

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.

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吸入皮质类固醇对新冠肺炎患者的影响：随机对照试验的系统回顾和荟萃分析。

背景：超过600万人死于新冠肺炎，10-15%的感染者患有新冠肺炎后综合征。皮质类固醇广泛用于治疗严重的新冠肺炎和急性后新冠肺炎症状。本研究综合了吸入皮质类固醇（ICS）对COVID-19患者死亡率、住院时间（LOS）和嗅觉评分改善的有效性的最新证据。方法：我们搜索了Embase、Web of Science、PubMed、Cochrane Library和Scopus，直到2022年8月。使用Cochrane偏倚风险工具评估研究质量。我们通过死亡率、LOS、急性新冠肺炎后症状的缓解、持续自我报告治愈的时间和嗅觉（视觉模拟量表（VAS））等指标，评估ICS对新冠肺炎患者的有效性。结果：荟萃分析包括10项研究。我们的研究显示，与安慰剂相比，ICS患者的LOS显著降低（MD=1.52，95%CI[2.77至-0.28]，p值=0.02）。接受鼻内皮质类固醇（INC）治疗的患者在第三周至第四周的VAS嗅觉评分显著改善（MD=1.53，95%CI[0.27至2.78]，p值=0.02），并在14天后缓解新冠肺炎相关症状（RR=1.17，95%CI[1.09至1.26]，p值<0.0001）。在死亡率（RR=0.69，95%CI[0.36至1.35]，p值=0.28）和持续自我报告治愈时间（MD=1.28，95%CI[6.77至4.20]，p值0.65）方面未发现显著差异新冠肺炎相关症状。INC可能在改善嗅觉评分方面发挥作用。因此，使用INC和ICS两周或更长时间可能是有益的。目前的数据没有显示对死亡率或持续自我报告治愈时间的影响。然而，证据是不确定的，需要更多的研究来获得更精确的数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Journal of Respiratory Therapy Health Professions-Health Professions (miscellaneous)

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： The CJRT is published four times a year and represents the interests of respiratory therapists nationally and internationally. The CJRT has been redesigned to act as an educational dissemination tool. The CJRT encourages submission of original articles, papers, commentaries, case studies, literature reviews and directed reading papers. Submissions can be sent to Rita Hansen.