Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis

• Autor(a) principal: Ferreto,Lirane Elize Defante
• Data de Publicação: 2021
• Outros Autores: Bortoloti,Durcelina Schiavoni, Fortes,Paulo Cezar Nunes, Follador,Franciele, Arruda,Gisele, Ximenez,João Paulo, Wendt,Guilherme Welter
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: São Paulo medical journal (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000600657
• topic: Dexamethasone; COVID-19; SARS-CoV-2; Meta-analysis [publication type]; Pulmonary medicine; Coronavirus pandemic; Drug repurposing; Respiratory medicine; Clinical trials

ABSTRACT BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. ­Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO platform: CRD42021229825.