Methodology: 4/5
Usefulness: 4/5

WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Sterne JAC et al. JAMA. 2020 Oct 6;324(13):1330-1341.

Question and Methods: Prospective meta-analysis of 7 RCTs investigating the utility of systemic corticosteroids, compared with usual care/placebo, in decreasing 28-day all-cause mortality of critically-ill COVID-19 patients. 
Findings: 222 deaths among 678 patients receiving steroids and 425 deaths among 1025 patients receiving usual care. Summary OR 0.66 [95% CI 0.53-0.82] favouring steroids.  
Limitations: Patient inclusion criteria was not explicit with heterogeneity in the definitions of ‘critically-ill’, ‘standard care’, and ‘adverse events’. The search criteria were also limited.   

Interpretation: In COVID-19 patients requiring supplemental oxygen or mechanical ventilation, this study demonstrates a decreased 28-day mortality associated with systemic corticosteroid administration.  

By: Dr. Wilson Lam

For more articles on COVID-19 check out this link.

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.