Table.

Summary of clinical evidence to date

	Outcomes of corticosteroid therapy*	Comment
MERS-CoV	Delayed clearance of viral RNA from respiratory tract2	Adjusted hazard ratio 0·4 (95% CI 0·2–0·7)
SARS-CoV	Delayed clearance of viral RNA from blood5	Significant difference but effect size not quantified
SARS-CoV	Complication: psychosis6	Associated with higher cumulative dose, 10 975 mg vs 6780 mg hydrocortisone equivalent
SARS-CoV	Complication: diabetes7	33 (35%) of 95 patients treated with corticosteroid developed corticosteroid-induced diabetes
SARS-CoV	Complication: avascular necrosis in survivors8	Among 40 patients who survived after corticosteroid treatment, 12 (30%) had avascular necrosis and 30 (75%) had osteoporosis
Influenza	Increased mortality9	Risk ratio for mortality 1·75 (95% CI 1·3–2·4) in a meta-analysis of 6548 patients from ten studies
RSV	No clinical benefit in children10, 11	No effect in largest randomised controlled trial of 600 children, of whom 305 (51%) had been treated with corticosteroids

CoV=coronavirus. MERS=Middle East respiratory syndrome. RSV=respiratory syncytial virus. SARS=severe acute respiratory syndrome.

^*Hydrocortisone, methylprednisolone, dexamethasone, and prednisolone.