Dexamethasone for treating SARS-CoV-2 infection

a systematic review and meta-analysis

Authors

Keywords:

Dexamethasone, COVID-19, SARS-CoV-2, Meta-analysis [publication type], Pulmonary medicine

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.

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Author Biographies

Lirane Elize Defante Ferreto, Universidade Estadual do Oeste do Paraná

PhD. Pharmacist and Associate Professor, Centro de Ciências da Saúde (CCS), Universidade Estadual do Oeste do Paraná (UNIOESTE), Francisco Beltrão (PR), Brazil.

Durcelina Schiavoni Bortoloti, Universidade Estadual do Oeste do Paraná

PhD. Physical Education Professional and Adjunct Professor of Research Methods, Department of Biological Sciences, Medical and Health, Universidade Paranaense (UNIPAR), Umuarama (PR), Brazil.

Paulo Cezar Nunes Fortes, Universidade Estadual do Oeste do Paraná

MD, PhD. Intensive Care Unit Physician and Adjunct Professor, Centro de Ciências da Saúde (CCS), Universidade Estadual do Oeste do Paraná (UNIOESTE), Francisco Beltrão (PR), Brazil.

Franciele Follador, Universidade Estadual do Oeste do Paraná

PhD. Chemist and Associate Professor, Centro de Ciências da Saúde (CCS), Universidade Estadual do Oeste do Paraná (UNIOESTE), Francisco Beltrão (PR), Brazil.

Gisele Arruda, Universidade Estadual do Oeste do Paraná

PhD. Biologist and Adjunct Professor, Centro de Ciências da Saúde (CCS), Universidade Estadual do Oeste do Paraná (UNIOESTE), Francisco Beltrão (PR), Brazil.

João Paulo Ximenez, Universidade Estadual do Oeste do Paraná

PhD. Pharmacist and Postdoctoral Researcher, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil.

Guilherme Welter Wendt, Universidade Estadual do Oeste do Paraná

PhD. Psychologist and Adjunct Professor of Quantitative Research Methods, Centro de Ciências da Saúde (CCS), Universidade Estadual do Oeste do Paraná (UNIOESTE), Francisco Beltrão (PR), Brazil.

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Published

2021-11-04

How to Cite

1.
Ferreto LED, Bortoloti DS, Fortes PCN, Follador F, Arruda G, Ximenez JP, Wendt GW. Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis. Sao Paulo Med J [Internet]. 2021 Nov. 4 [cited 2025 Mar. 9];139(6):657-61. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/546

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Short Communication