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. 2022 Nov 17;2022(11):CD014963. doi: 10.1002/14651858.CD014963.pub2

Tang 2021.

Study characteristics
Methods Trial design: prospective, multicentre, single‐blind RCT
Type of publication: journal publication
Setting: inpatient
Recruitment dates: 19 February 2020 to 31 March 2020
Country: China
Language: English
Number of centres: 7
Trial registration number: NCT04273321
Date of trial registration: 15 February 2020
Participants Age: median age
  • 57 years (IQR 49 to 67) in the intervention group

  • 55 years (IQR 38 to 65) in the control group


Gender
  • 21 male (48.8%) in the intervention group

  • 20 male (46.5%) in the control group


Proportion of confirmed infections: PCR positivity inclusion criterion
Ethnicity: not reported
Number of participants (recruited/allocated/evaluated):
  • 213

  • Allocated: 43 in the intervention group and 43 in the control group

  • Evaluated: 43 in the intervention group and 43 in the control group


Severity of condition according to study definition:
  • COVID‐19 pneumonia (confirmed by chest‐CT)

  • Admitted to the general wards


Severity of condition according to WHO score: moderate to severe 4 to 6
Co‐morbidities: COPD, asthma, hypertension, coronary heart disease, diabetes, chronic renal failure
Inclusion criteria
  • Age > 18 years old

  • Confirmed SARS‐CoV‐2 infection

  • Admitted in the general wards

  • Able to sign informed consent


Exclusion criteria
  • Severe immunosuppression (HIV infection, long‐term use of immunosuppressive agents)

  • Pregnant or lactation period women

  • Glucocorticoids are needed for other diseases

  • Unwilling or unable to participate or complete the study

  • Participating in other study


Previous treatments: not reported
Interventions Treatment details of intervention group (e.g. dose, route of administration, number of doses)
  • Type of corticosteroid: methylprednisolone

  • Dose: 1 mg/kg/day in 100 mL 0.9% NaCl for 7 days

  • Route of administration: intravenous


Treatment details of control group (e.g. dose, route of administration, number of doses)
  • 100 mL 0.9% NaCl IV and standard care


Concomitant therapy (e.g. description of standard care): standard therapy of COVID‐19: according to the Chinese Diagnosis and Treatment Plan for COVID‐19 (trial version 6); antivirals: 67 (77.9%) of patients, antibiotics: 61 (70.9%) of patients
Duration of follow‐up: at least 14 days after randomisation or until hospital discharge
Treatment cross‐overs: none documented
Compliance with assigned treatment: yes
Outcomes Primary study outcome: clinical deterioration 14 days after randomisation
Review outcomes: inpatient setting
  • Mortality: all‐cause mortality at day 14 or any longer observation period, in‐hospital all‐cause mortality: reported

  • Improvement of clinical status during the longest observation period available:

    • Ventilator‐free days (defined as days alive and free from mechanical ventilation): not reported

    • Participants discharged alive. Participants should be discharged without clinical deterioration or death: not reported

  • Deterioration of clinical status during the longest observation period available:

    • New need for invasive mechanical ventilation or death; that is, transition to WHO 7 to 9 if 6 or lower at baseline (see Figure 1): not reported

  • Serious adverse events, defined as the number of participants with any event: not reported

  • Adverse events (any grade), defined as the number of participants with any event: reported

  • Specific adverse events: hospital‐acquired infections: reported

  • Fungal infections: not reported

  • Quality of life, including fatigue and neurological status, assessed with standardised scales (e.g. WHOQOL‐100) during the longest period available: not reported

  • New need for dialysis during the longest period available: not reported

  • Viral clearance, assessed with reverse transcription polymerase chain reaction (RT‐PCR) test for SARS‐CoV‐2 at baseline, up to 3, 7, and 15 days: reported


Additional study outcomes: clinical deterioration 14 days after randomisation (defined as deterioration of clinical signs and symptoms, new pulmonary or extrapulmonary lesions, progress in chest CT, ICU admission or death); clinical cure 14 days after randomisation (defined as improvement of clinical signs and symptoms of COVID‐19 and no need of additional therapy); time from randomisation to clinical cure, median (IQR), days; ICU admission
Identification  
Notes Date of publication: 22 January 2021
Sponsor/funding: Beijing Chao Yang Hospital