Glucocorticoids

44.9 % of patients received this therapy

Patients with CRP levels >20 mg/dL might benefit from use of glucocorticoids, wheres grucocorticoid treatment might harm patients with CRP levels <10 mg/dL. Sample size: 140 + 1,666 control.

Glucocorticoid treatment does not impede the SARS-CoV-2 viral clearance or change peripheral lymphocyte counts. Sample size: 684. Dosage: Most common methylprednisolone 1–2 mg/kg daily for 3 to 5.

There was no significant difference in oxygen supply duration in severe/critical patients or patients with CRP above 20 mg/L at the baseline who were treated with glucocorticoids compared to the respective control group even though their general clinical condition prior to the glucocorticoid therapy was more severe. From this the authors imply that glucocorticoid therapy provides some benefit for severe/critical COVID-19 patients. The data did not support such conclusion for non-severe patients or for patients with CRP below 20 mg/L at the baseline. Sample size: 174 + 621 control (non-severe cohort); 254 + 398 control (severe cohort).

Patients with severe COVID-19 pneumonia might benefit from higher doses of glucocorticoids (≥250 mg of prednisone equivalent daily). Sample size: 47 (lower glucocorticoid dosing) + 56 (higher glucocorticoid dosing) + 156 control. Dosage: Less than 250 mg of maximum prednisone equivalent daily or 250 mg or more of maximum prednisone equivalent daily for 3–5 days.

Glucocorticoids with or without anakinra decreased death rate in the cohort of non-ICU patients at the stage of cytokine release caused by COVID-19. Sample size: 108 + 63 control. Dosage: 120 mg of methylprednisolone daily for three days followed by dose de-escalation with methylprednisolone or equivalents. Main outcome: Death within 15 days of hospitalization.