Table 1.
Summary of the most relevant characteristics of meta-analyses published that have assessed the effects of corticosteroids in patients hospitalized with community-acquired pneumonia with the main outcomes reported
| Author | Year | N RCTs | N patients | Mortalitya | Mortality (SCAP)a | LOSb | TTCSb | Hyperglycaemiaa | GI bleeding | Other side effectsa |
|---|---|---|---|---|---|---|---|---|---|---|
| Siempos | 2008 | 8 | 189 SCAP | – | 0.21 (0.05–0.83) | Reduced (NE) | – | – | – | – |
| Nie | 2012 | 9 | 1001 | 0.62 (0.32–1.04) | 0.26 (0.11–0.64) | – | – | 2.64 (1.68–4.15) | Similar | Similar superinfection |
| Cheng | 2014 | 4 | 264 SCAP | – | 0.39 (0.17–0.90) | Decreased In ICU | – | – | Similar | – |
| Siemieniuk | 2015 | 12 | 1974 | 0.67 (0.45–1.01) | – | − 1.00 (− 1.79 to − 0.21) | − 1.22 (− 2.08 to − 0.35) | 1.49 (1.01–2.19 | Similar | MV: 0.45 (0.26–0.49) ARDS: 0.24 (0.10–0.56) |
| Horita | 2015 | 10 | 1780 | 0.80 (0.53–1.21) | 0.41 (0.19–0.90) | − 0.98 (− 1.26 to − 0.71) | − 1.16 (− 1.73 to − 0.58) | Increased (NE) | – | – |
| Marti | 2015 | 14 | 2077 | 0.84 (0.55–1.29) | 0.47 (0.23–0.96) | 0.89c (0.70–0.89) | 0.89c (0.84–0.94) | 1.59 (1.06–2.38) | Similar | MV: 0.41 (0.29–0.60) |
| Wand | 2016 | 9 | 1667 | 0.72 (0.43–1.21) | 0.64 (0.32–1.29) | Reduced (NE) | Reduced (NE) | Similar | Similar | ARDS: 0.21 (0.08–0.59) |
| Bi | 2016 | 8 | 538 SCAP | – | 0.46 (0.28–0.77) | − 4.76 (− 8.13 to 1.40) | – | Similar | Similar | MV: 0.50 (0.27–0.91) ARDS: 0.23 (0.07–0.80) |
| Wu | 2017 | 10 | 729 SCAP | – | 0.49 (0.29–0.85) | − 4.11 (− 6.61 to 1.81) | – | – | – | – |
| Briel | 2017 | 6 | 1506 (individual) | 0.75 (0.46–1.21) | – | − 1.15 (− 1.75 to − 0.55) | − 1.63 (− 1.62 to − 0.43) | 2.15 (1.60–2.90) | – | CAP-related re-admission 1.85 (1.03–3.32) |
RCT randomised clinical trials, SCAP severe community-acquired pneumonia, NE not estimated, LOS length of stay in hospital, unless otherwise stated, TTCS time to clinical stability, GI gastrointestinal, ICU intensive care unit, MV mechanical ventilation, ARDS acute respiratory distress syndrome
aValues correspond to odds radios or risk ratios, with 95% confidence intervals in parentheses
bValues correspond to weighted mean differences in days, with 95% confidence intervals in parentheses
cValues correspond to geometrical mean ratios, with 95% confidence intervals in parentheses
dThis study also included six cohort studies with 4095 cases, but estimates are reported only from the nine RCTs