Table 1.

Overview of the main clinical studies considering the corticosteroid therapy in patients with SARS-COV-2 infection

Study		Saple size and COVID-19 severity	Corticosteroid regimen	Primary endpoint of efficacy/effect	Effect on viral clearance	Effect on mortality
Coral et al	[40]	85, severe COVID pneumonia	Methylprednisolone 40 mg twice daily for 3 days followed by 20 mg twice daily for 3 days	The need for ICU, noninvasive ventilation-reduced	Not considered	risk ratio in intention to treat analysis 0.55 and 0.61 in those patients over 75 years of age
Fadel et al	[41]	213 severe non critically ill COVID-19 pneumonia	Methylprednisolone 0.5–1 mg/kg/daily for 3 days	Care escalation (progression to critically ill, need for mechanical ventilation, mortality)-reduced	Not considered	Reduced mortality rates 26.3% with standard of care versus 13.6% in corticosteroid group
The Writing Committee for the REMAP-CAP  Investigators	[42]	137,146,101	Hydrocortisone 50 or 100 mg every 6 day for 7 days, hydrocortisone 50 mg every 6 hours (for confirmed shock), no corticosteroid	Number of organ support free days in the ICU over the first 21 days	In favor of corticosteroids, trial early terminated	Mortality rates respectively 30%, 26%, and 33% for each of the three regimens
Recovery Collaborative Group	[45]	6452(2104 in dexamethasone group) various severities (COVID-19 requiring hospitalization	Dexamethasone 6 mg/daily up to 10 days	Mortality rate within the first 28 days from randomization-reduced	Not considered	Mortality rate 25.7% in control group and 22.9 with dexamethasone P < 0.001
Li Q et al	[50]	475 non-severe COVID 19	Methylprednisolone 20–40 mg/daily for a maximum of 5 days	Progression to severe disease or death – more likely if corticosteroids were used	Significantly prolonged (18 versus 11 days)	1.8% in corticosteroid group, 0% in no corticosteroid group, p = 0.3
Xu et al	[51]	113 non-severe COVID 19	Corticosteroids, various regimens	Not designed to measure efficacy	Significantly prolonged in patients under corticosteroids
Li TZ et al	[52]	101 various severitied hospitalized COVID-19	Corticosteroids, various regimens	Not designed to measure efficacy	Significantly prolonged in patients under corticosteroids (OR = 6.3)	Overall 3,3 (0 for those with viral shedding lasting less than 11 days, respectively 6.5% for those with a viral shedding lasting more than 11 days
Tomazzini et al	[46]	299 moderate to severe SARS-COV2(151 in dexamethasone arm, 148 in control arm	Dexametasone intravenous 20 mg/daily for 5 days followed by 10 mg the following 5 days or up to ICU discharge	Number of ventilator free days at 28 day from admission-increased	Not considered	All cause mortality rate at 8 days was 56.3% in the dexamethasone group and 61.5% in the control group (p = 0.8)
Salton et al	[53]	173 severe COVID-19 pneumonia	Methylprednisolone- loading dose of 80 mg intravenous bolus, followed by daily infused identical doses at least 8 days, could be further prolonged based on severity	Care escalation due to disease progression (ICU, mechanical ventilation) or death-significantly reduced	Not considered	Mortality rates 7.2% in corticosteroid group compared to 23.3% in the standard of care group, (p = 0.005)