Immunomodulatory therapy for the management of critically ill patients with COVID-19: A narrative review

Table 4 Summary of studies using corticosteroids in coronavirus disease 2019

Ref.	Patients	Treatment regimen	Population	Mortality2	ICU administration	In-hospital stay	Secondary infections
RECOVERY Collaborative Group et al[177], RCT	11303	DXM 6 mg daily × 10 d	In-hospital	Decrease 2.8% RR 0.83	NS	Increase discharged 28 d (3.7%)	NA
RECOVERY Collaborative Group et al[177], RCT	1007	DXM 6 mg daily × 10 d	MV	Decrease 12.1% RR 0.64	NA	Increased discharged 28 d (9.7% RR 1.48)	NA
Tomazini et al[176], RCT	299	DXM 20 mg × 5d + DXM 10 mg × 5d	ICU patients	Decrease 2.4% (alive or ventilator-free)		NA	DXM 21.9% vs 29.1% standard. (7.9% vs 9.5% bacteremia)
Jeronimo et al[178], RCT	416	MPD (0.5 mg/kg twice daily) × 5d	In-hospital	NS	NS (MV)	NS	No significant differences
Dequin et al[179], RCT	149	HCT 200 mg daily × 7d then decrease dose × 7d (14 d)	ICU patients	NS		NS	NA
Angus et al[180], RCT	384	HCT 50 or 100 mg/6 h × 7 d	ICU patients	93% and 80% of superiority in organ support free		NS	NA
Edalatifard et al[181], RCT	68	MPD 250 mg × 3 d	In-hospital	Decrease 37%	No patients on MV	Decrease 4.6 d	2.9% (1 pt) in MPD vs 0% (0 pt) standard
Corral-Gudino et al[188], RCT1	85	MPD 40 mg/12 h × 3 d, then MPD 20 mg/12 h × 3 d	In-hospital	Decrease 24% composite death, ICU Adm or NIV		NS	NA
Kim et al[186], MA	49569	Variable regimens	ICU patients	OR 0.54 (0.40-0.73)	NA	NS	NA
Van Paassen et al[187], MA	20197	Variable regimens	In- hospital	OR 0.72 (0.57-0.87)	RR 0.71 (0.54-0. 97)	NS	NA

¹Preprint, not peer-reviewed.

²Absolute risk of mortality reduction in randomized clinical trial or odds ratio in meta-analysis.

ICU: Intensive care unit; RCT: Randomized clinical trial; MA: Meta-analysis; DXM: Dexamethasone; MPD: Methylprednisolone; HCT: Hydrocortisone; NS: Non-significant; NA: Not applicable; Adm: Admission; MV: Mechanical ventilation; NIV: Non-invasive ventilation; RR: Relative risk; OR: Odds ratio.