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Review
. 2021;7(1):67.
doi: 10.1186/s43094-021-00217-3. Epub 2021 Mar 17.

Therapeutic role of corticosteroids in COVID-19: a systematic review of registered clinical trials

Reshma Raju  1 , Prajith V  1 , Pratheeksha Sojan Biatris  1 , Sam Johnson Udaya Chander J  1
Affiliations
Review

Therapeutic role of corticosteroids in COVID-19: a systematic review of registered clinical trials

Reshma Raju et al. Futur J Pharm Sci. 2021.

Abstract

Background: In March 2020, the World Health Organization declared the coronavirus disease 2019 as a global pandemic. Though antiviral drugs and antimalarial drugs are considered treatment options for treating coronavirus disease 2019 (COVID-19), no specific antivirals are currently available for its treatment. Efficient use of drug discovery approaches including repurposing or repositioning of drugs used in the treatment of severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) is considered recently. The widespread application of corticosteroid therapy in COVID-19 should be backed with careful documented pragmatic research of its use in this context.

Main body: This article aims to analyze various trials registered across the globe providing an overall picture of the use of corticosteroids in the treatment of COVID-19. An extensive search was conducted on the clinical trial registries around the world to identify all the trials reporting information regarding the use of corticosteroids in COVID-19. Our initial search returned 231 trials, out of which 60 trials were finally included in the analysis. Fifty-six studies were interventional trials, and all the trials had clearly defined primary and secondary outcomes of interest, of which only 11 trials had evaluation of respiratory rate as one of their outcomes.

Conclusion: Few preliminary trial findings show promising results and recommend the use of methylprednisolone and dexamethasone in the severe form of the disease; however, there is insufficient data to prove its benefits over its risks. Routine use of corticosteroids should be favored only after a better insight is obtained, with the completion of these trials.

Keywords: Hydrocortisone; Methylprednisolone; SARS-CoV2, Clinical trial registry; Steroids, COVID-19.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Global COVID-19 spread showing number of confirmed cases as of 30 January 2021 (Source: https://covid19.who.int/)
Fig. 2
Fig. 2
PRISMA flow diagram of reporting search results
Fig. 3
Fig. 3
Number of trials using different kinds of steroids
See this image and copyright information in PMC

References

    1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W, China Novel Coronavirus Investigating and Research Team A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, Haagmans BL, Lauber C, Leontovich AM, Neuman BW, Penzar D, Perlman S, Poon LLM, Samborskiy D, Sidorov IA, Sola I, Ziebuhr J. Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group. Nat Microbiol. 2020;5:536–544. doi: 10.1038/s41564-020-0695-z. - DOI - PMC - PubMed
    1. WHO. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. Available from: https://www.who.int/zh/dg/speeches/detail/who-director-general-s-remarks.... Accessed 25 June 2020.
    1. He F, Deng Y, Li W. Coronavirus disease 2019 (COVID-19): what we know? J Med Virol. 2020;92(7):719–725. doi: 10.1002/jmv.25766. - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed

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