A systematic review and meta-analysis of the efficacy and safety of glucocorticoids in the treatment of severe pneumonia

TL;DR

This study reviews and analyzes the effectiveness and safety of glucocorticoids in treating severe pneumonia, finding they improve recovery times and reduce inflammation.

Contribution

A systematic review and meta-analysis of glucocorticoid efficacy in severe pneumonia, highlighting clinical benefits and calling for more high-quality studies.

Findings

Glucocorticoids improved temperature recovery, cough relief, and rale disappearance times in severe pneumonia patients.

They reduced hospital stay duration and regulated serum CRP levels, indicating anti-inflammatory effects.

No significant differences were found in adverse reactions, mortality, or reinfection rates between groups.

Abstract

•Glucocorticoids could effectively improve the condition of patients with severe pneumonia.•Glucocorticoids could effectively shorten the temperature recovery time, cough relief time, and rale disappearance time.•Glucocorticoids could effectively reduce the length of stay, and regulate the serum CRP level.

Glucocorticoids could effectively improve the condition of patients with severe pneumonia.

Glucocorticoids could effectively shorten the temperature recovery time, cough relief time, and rale disappearance time.

Glucocorticoids could effectively reduce the length of stay, and regulate the serum CRP level.

To systematically evaluate the efficacy and superiority of glucocorticoids in the treatment of severe pneumonia.

Randomized Controlled Trials (RCTs) on glucocorticoids in the treatment of severe pneumonia were retrieved from CNKI, CBM, China Science and Technology Journal Database (VIP), Wanfang Database, and PubMed as of January 1, 2017. The literature was independently and objectively screened, extracted, and evaluated by two researchers, and a meta-analysis of the extracted data was performed using Revman 5.3 software.

Ten studies that met the inclusion criteria were included, with a cumulative total of 1120 cases. The meta-analysis results confirmed that the observation group was superior to the control group in terms of efficacy rate, temperature recovery time, cough relief time, rale disappearance time, and serum CRP level. There was no statistically significant difference in terms of the incidence of adverse reactions, mortality rate, and reinfection rate between the two groups.

Glucocorticoids showed an obvious clinical efficacy in patients with severe pneumonia. However, due to the small number of included studies and the ambiguity of numerous bias risk assessments, high-quality and large-sample RCTs are still needed to provide corroborating evidence.

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