Steroids in acute respiratory distress syndrome: A panacea or still a puzzle?

Table 6 List of recent systematic reviews and metanalysis on steroids in acute respiratory distress syndrome

Ref.	Number and type of studies included	Number of patients	Type of patient population	Primary outcome	Remarks
Ni et al[23], 2019	10, observational studies	6548	Adults with influenza pneumonia	Mortality	Mortality higher in patients receiving corticosteroids
van Passen et al[37], 2020	44, observational studies and RCTs	20,197	Adults with COVID-19 diagnosed by RT-PCR	Short-term mortality and viral clearance (based on RT-PCR in respiratory specimens)	Reduced short-term mortality. However, signal for delayed viral clearance
Lin et al[39], 2021	9, RCTs	1371	Adults with ARDS	Hospital mortality	Heterogeneity in the studies included
Chaudhuri et al[38], 2021	18, RCTs	2826	Adults with ARDS (including patients with COVID-19)	Mortality	Largest metanalysis examining corticosteroids in ARDS of any cause
Chang et al[40], 2022	14, RCTs	1607	Any age with ARDS of any cause	28-d mortality	Included children in the participants of metanalysis, found mortality benefit with corticosteroids
Yoshihito et al[41], 2022	9, RCTs	1212	Adults with ARDS	Hospital mortality	No significant difference found

COVID-19: Coronavirus disease 2019; RT-PCR: Reverse transcription polymerase chain reaction; ARDS: Acute respiratory distress syndrome.