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. 2022 Feb;11(2):194-203.
doi: 10.21037/tp-21-577.

Safety of corticosteroids in the treatment of acute respiratory disease in children: a systematic review and meta-analysis

Xiaoyun Yang  1 , Hui Jin  1
Affiliations

Safety of corticosteroids in the treatment of acute respiratory disease in children: a systematic review and meta-analysis

Xiaoyun Yang et al. Transl Pediatr. 2022 Feb.

Abstract

Background: Oral corticosteroids are often used to treat acute asthma or asthma caused by respiratory tract infection in adult patients, but the effect of oral corticosteroids in young children is still controversial. We conducted a meta-analysis of controlled clinical studies to examine the effect of oral corticosteroids in children with respiratory diseases.

Methods: Embase, PubMed, Web of Science, Ovid, ClinicalTrials.org from January 2000 to August 2021 were searched for randomized control trials related to the treatment of pediatric respiratory diseases with corticosteroid drugs using the keywords "corticosteroids" and "acute respiratory diseases". After screening the articles, Revman 5.4 software was used for the analysis.

Results: A total of 8 articles (comprising 2,327 patients, 4 kinds of corticosteroids, and 3 types of pediatric respiratory disease) were included in the meta-analysis. The results showed that the length of hospital stay of patients in the experimental group treated with corticosteroids was shorter than that of patients in the control group [mean difference =-2.03, 95% confidence interval (CI): -2.91, -1.14; P<0.00001]. Further, the number and proportion of uncured patients after 3 days of treatment were lower in the experimental group than the control group [odds ratio (OR) =0.55, 95% CI: 0.42, 0.72; P<0.00001]. There were no differences in relation to adverse reactions (OR =0.57, 95% CI: 0.31, 1.07; P=0.08), and the readmission rate between the experimental and control groups (OR =0.94, 95% CI: 0.66, 1.34; P=0.75).

Discussion: Corticosteroid use in the treatment of respiratory diseases in children can significantly shorten hospitalization time and increase the cure rate without increasing adverse reactions.

Keywords: Corticosteroids; acute respiratory disease; meta-analysis.

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Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-21-577/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The selection flow chart.
Figure 2
Figure 2
Summary chart of risk of bias assessment of included articles.
Figure 3
Figure 3
Risk of bias assessment chart of the included articles.
Figure 4
Figure 4
Effect of corticosteroid drugs on length of hospital stay in children with respiratory diseases.
Figure 5
Figure 5
Effect of corticosteroid drugs on the number of children with respiratory diseases who were not cured after 3 days of treatment.
Figure 6
Figure 6
Adverse reactions of corticosteroids in children with respiratory disease.
Figure 7
Figure 7
Effect of corticosteroids on the long-term re-hospitalization rate in children with respiratory diseases.
Figure 8
Figure 8
Funnel plot of corticosteroid therapy.
See this image and copyright information in PMC

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