Serveur d'exploration sur la COVID en France

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Corticosteroid therapy for critically ill patients with COVID-19: A structured summary of a study protocol for a prospective meta-analysis of randomized trials.

Identifieur interne : 001213 ( Main/Exploration ); précédent : 001212; suivant : 001214

Corticosteroid therapy for critically ill patients with COVID-19: A structured summary of a study protocol for a prospective meta-analysis of randomized trials.

Auteurs : Jonathan A C. Sterne [Royaume-Uni] ; Janet Diaz [Suisse] ; Jesús Villar [Espagne] ; Srinivas Murthy [Canada] ; Arthur S. Slutsky [Canada] ; Anders Perner [Danemark] ; Peter Jüni [Canada] ; Derek C. Angus [États-Unis] ; Djillali Annane [France] ; Luciano Cesar Pontes Azevedo [Brésil] ; Bin Du [République populaire de Chine] ; Pierre-Francois Dequin [France] ; Anthony C. Gordon [Royaume-Uni] ; Cameron Green [Australie] ; Julian P T. Higgins [Royaume-Uni] ; Peter Horby [Royaume-Uni] ; Martin J. Landray [Royaume-Uni] ; Giuseppe Lapadula [Italie] ; Amelie Le Gouge [France] ; Marie Leclerc [France] ; Jelena Savovi [Royaume-Uni] ; Bruno Tomazini [Brésil] ; Balasubramanian Venkatesh [Australie] ; Steve Webb [Australie] ; John C. Marshall [Canada]

Source :

RBID : pubmed:32831155

Descripteurs français

English descriptors

Abstract

OBJECTIVES

Primary objective: To estimate the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization. Secondary objectives: To examine whether the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization varies between subgroups related to treatment characteristics, disease severity at the time of randomization, patient characteristics, or risk of bias. To examine the effect of corticosteroids compared with usual care or placebo on serious adverse events.

STUDY DESIGN

Prospective meta-analysis of randomized controlled trials. Both placebo-controlled and open-label trials are eligible.

PARTICIPANTS

Hospitalised, critically ill patients with suspected or confirmed COVID-19.

INTERVENTION AND COMPARATOR

Intervention groups will have received therapeutic doses of a steroid (dexamethasone, hydrocortisone or methylprednisolone) with IV or oral administration immediately after randomization. The comparator groups will have received standard of care or usual care or placebo.

MAIN OUTCOME

All-cause mortality up to 28 days after randomization.

SEARCH METHODS

Systematic searching of clinicaltrials.gov , EudraCT, the WHO ISRCTN registry, and the Chinese clinical trials registry. Additionally, research and WHO networks will be asked for relevant trials.

RISK OF BIAS ASSESSMENTS

These will be based on the Cochrane RoB 2 tool, and will use structured information provided by the trial investigators on a form designed for this prospective meta-analysis. We will use GRADE to assess the certainty of the evidence.

STATISTICAL ANALYSES

Trial investigators will provide data on the numbers of participants who did and did not experience each outcome according to intervention group, overall and in specified subgroups. We will conduct fixed-effect (primary analysis) and random-effects (Paule-Mandel estimate of heterogeneity and Hartung-Knapp adjustment) meta-analyses. We will quantify inconsistency in effects between trials using I

PROSPERO REGISTRATION NUMBER

CRD42020197242 FULL PROTOCOL: The full protocol for this prospective meta-analysis is attached as an additional file, accessible from the Trials website (Additional file 1). To expedite dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol for the systematic review.


DOI: 10.1186/s13063-020-04641-3
PubMed: 32831155
PubMed Central: PMC7443535


Affiliations:


Links toward previous steps (curation, corpus...)


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<wicri:regionArea>NIHR Bristol Biomedical Research Centre, Bristol</wicri:regionArea>
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</affiliation>
</author>
<author>
<name sortKey="Diaz, Janet" sort="Diaz, Janet" uniqKey="Diaz J" first="Janet" last="Diaz">Janet Diaz</name>
<affiliation wicri:level="1">
<nlm:affiliation>Clinical Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland.</nlm:affiliation>
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>Clinical Unit, Health Emergencies Programme, World Health Organization, Geneva</wicri:regionArea>
<wicri:noRegion>Geneva</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Villar, Jesus" sort="Villar, Jesus" uniqKey="Villar J" first="Jesús" last="Villar">Jesús Villar</name>
<affiliation wicri:level="1">
<nlm:affiliation>Research Unit, Hospital Universitario Dr. Negrin Las Palmas de Gran Canaria, Las Palmas, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Research Unit, Hospital Universitario Dr. Negrin Las Palmas de Gran Canaria, Las Palmas</wicri:regionArea>
<wicri:noRegion>Las Palmas</wicri:noRegion>
</affiliation>
<affiliation wicri:level="3">
<nlm:affiliation>CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Murthy, Srinivas" sort="Murthy, Srinivas" uniqKey="Murthy S" first="Srinivas" last="Murthy">Srinivas Murthy</name>
<affiliation wicri:level="3">
<nlm:affiliation>Department of Pediatrics, University of British Columbia, Vancouver, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Pediatrics, University of British Columbia, Vancouver</wicri:regionArea>
<placeName>
<settlement type="city">Vancouver</settlement>
<region type="state">Colombie-Britannique</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Slutsky, Arthur S" sort="Slutsky, Arthur S" uniqKey="Slutsky A" first="Arthur S" last="Slutsky">Arthur S. Slutsky</name>
<affiliation wicri:level="4">
<nlm:affiliation>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto</wicri:regionArea>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
<orgName type="university">Université de Toronto</orgName>
</affiliation>
</author>
<author>
<name sortKey="Perner, Anders" sort="Perner, Anders" uniqKey="Perner A" first="Anders" last="Perner">Anders Perner</name>
<affiliation wicri:level="3">
<nlm:affiliation>Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Intensive Care, Rigshospitalet, Copenhagen</wicri:regionArea>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Juni, Peter" sort="Juni, Peter" uniqKey="Juni P" first="Peter" last="Jüni">Peter Jüni</name>
<affiliation wicri:level="4">
<nlm:affiliation>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto</wicri:regionArea>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
<orgName type="university">Université de Toronto</orgName>
</affiliation>
</author>
<author>
<name sortKey="Angus, Derek C" sort="Angus, Derek C" uniqKey="Angus D" first="Derek C" last="Angus">Derek C. Angus</name>
<affiliation wicri:level="2">
<nlm:affiliation>Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA</wicri:regionArea>
<placeName>
<region type="state">Pennsylvanie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Annane, Djillali" sort="Annane, Djillali" uniqKey="Annane D" first="Djillali" last="Annane">Djillali Annane</name>
<affiliation wicri:level="3">
<nlm:affiliation>Department of Intensive Care, Raymond Poincaré Hospital (APHP), School of Medicine Simone Veil, University Paris Saclay -UVSQ, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Intensive Care, Raymond Poincaré Hospital (APHP), School of Medicine Simone Veil, University Paris Saclay -UVSQ, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Azevedo, Luciano Cesar Pontes" sort="Azevedo, Luciano Cesar Pontes" uniqKey="Azevedo L" first="Luciano Cesar Pontes" last="Azevedo">Luciano Cesar Pontes Azevedo</name>
<affiliation wicri:level="3">
<nlm:affiliation>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo, Brazil.</nlm:affiliation>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo</wicri:regionArea>
<placeName>
<settlement type="city">São Paulo</settlement>
<region type="state">État de São Paulo</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name>
<affiliation wicri:level="3">
<nlm:affiliation>Peking Union Medical College Hospital, Beijing, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Peking Union Medical College Hospital, Beijing</wicri:regionArea>
<placeName>
<settlement type="city">Pékin</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Dequin, Pierre Francois" sort="Dequin, Pierre Francois" uniqKey="Dequin P" first="Pierre-Francois" last="Dequin">Pierre-Francois Dequin</name>
<affiliation wicri:level="3">
<nlm:affiliation>Médecine Intensive - Réanimation, INSERM CIC1415, CHRU de Tours, Tours, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Médecine Intensive - Réanimation, INSERM CIC1415, CHRU de Tours, Tours</wicri:regionArea>
<placeName>
<region type="region">Centre-Val de Loire</region>
<region type="old region">Région Centre</region>
<settlement type="city">Tours</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="4">
<nlm:affiliation>CRICS-TriGGERSep network, Centre d'Etude des Pathologies Respiratoires, Université de Tours, Tours, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>CRICS-TriGGERSep network, Centre d'Etude des Pathologies Respiratoires, Université de Tours, Tours</wicri:regionArea>
<placeName>
<region type="region">Centre-Val de Loire</region>
<region type="old region">Région Centre</region>
<settlement type="city">Tours</settlement>
</placeName>
<orgName type="university">Université de Tours</orgName>
</affiliation>
</author>
<author>
<name sortKey="Gordon, Anthony C" sort="Gordon, Anthony C" uniqKey="Gordon A" first="Anthony C" last="Gordon">Anthony C. Gordon</name>
<affiliation wicri:level="3">
<nlm:affiliation>Division of Anaesthetics, Pain Medicine & Intensive Care, Imperial College London, London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Anaesthetics, Pain Medicine & Intensive Care, Imperial College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Green, Cameron" sort="Green, Cameron" uniqKey="Green C" first="Cameron" last="Green">Cameron Green</name>
<affiliation wicri:level="3">
<nlm:affiliation>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne</wicri:regionArea>
<placeName>
<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Higgins, Julian P T" sort="Higgins, Julian P T" uniqKey="Higgins J" first="Julian P T" last="Higgins">Julian P T. Higgins</name>
<affiliation wicri:level="1">
<nlm:affiliation>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol</wicri:regionArea>
<wicri:noRegion>Bristol</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:affiliation>NIHR Bristol Biomedical Research Centre, Bristol, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NIHR Bristol Biomedical Research Centre, Bristol</wicri:regionArea>
<wicri:noRegion>Bristol</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:affiliation>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol</wicri:regionArea>
<wicri:noRegion>Bristol</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Horby, Peter" sort="Horby, Peter" uniqKey="Horby P" first="Peter" last="Horby">Peter Horby</name>
<affiliation wicri:level="4">
<nlm:affiliation>Nuffield Department of Medicine, University of Oxford, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Medicine, University of Oxford, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
</author>
<author>
<name sortKey="Landray, Martin J" sort="Landray, Martin J" uniqKey="Landray M" first="Martin J" last="Landray">Martin J. Landray</name>
<affiliation wicri:level="4">
<nlm:affiliation>Nuffield Department of Population Health, University of Oxford, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Nuffield Department of Population Health, University of Oxford, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation wicri:level="4">
<nlm:affiliation>MRC Population Health Research Unit, University of Oxford, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>MRC Population Health Research Unit, University of Oxford, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation wicri:level="3">
<nlm:affiliation>NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lapadula, Giuseppe" sort="Lapadula, Giuseppe" uniqKey="Lapadula G" first="Giuseppe" last="Lapadula">Giuseppe Lapadula</name>
<affiliation wicri:level="1">
<nlm:affiliation>Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza</wicri:regionArea>
<wicri:noRegion>Monza</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Le Gouge, Amelie" sort="Le Gouge, Amelie" uniqKey="Le Gouge A" first="Amelie" last="Le Gouge">Amelie Le Gouge</name>
<affiliation wicri:level="3">
<nlm:affiliation>CIC INSERM 1415 - CHRU de Tours, Hôpital Bretonneau, Tours, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>CIC INSERM 1415 - CHRU de Tours, Hôpital Bretonneau, Tours</wicri:regionArea>
<placeName>
<region type="region">Centre-Val de Loire</region>
<region type="old region">Région Centre</region>
<settlement type="city">Tours</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Leclerc, Marie" sort="Leclerc, Marie" uniqKey="Leclerc M" first="Marie" last="Leclerc">Marie Leclerc</name>
<affiliation wicri:level="3">
<nlm:affiliation>Délégation à la Recherche Clinique et à l'Innovation, CHRU de Tours, Tours, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Délégation à la Recherche Clinique et à l'Innovation, CHRU de Tours, Tours</wicri:regionArea>
<placeName>
<region type="region">Centre-Val de Loire</region>
<region type="old region">Région Centre</region>
<settlement type="city">Tours</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Savovi, Jelena" sort="Savovi, Jelena" uniqKey="Savovi J" first="Jelena" last="Savovi">Jelena Savovi</name>
<affiliation wicri:level="1">
<nlm:affiliation>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol</wicri:regionArea>
<wicri:noRegion>Bristol</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:affiliation>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol</wicri:regionArea>
<wicri:noRegion>Bristol</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tomazini, Bruno" sort="Tomazini, Bruno" uniqKey="Tomazini B" first="Bruno" last="Tomazini">Bruno Tomazini</name>
<affiliation wicri:level="3">
<nlm:affiliation>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo, Brazil.</nlm:affiliation>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo</wicri:regionArea>
<placeName>
<settlement type="city">São Paulo</settlement>
<region type="state">État de São Paulo</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Venkatesh, Balasubramanian" sort="Venkatesh, Balasubramanian" uniqKey="Venkatesh B" first="Balasubramanian" last="Venkatesh">Balasubramanian Venkatesh</name>
<affiliation wicri:level="3">
<nlm:affiliation>George Institute for Global Health, University of New South Wales, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>George Institute for Global Health, University of New South Wales, Sydney</wicri:regionArea>
<placeName>
<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Webb, Steve" sort="Webb, Steve" uniqKey="Webb S" first="Steve" last="Webb">Steve Webb</name>
<affiliation wicri:level="3">
<nlm:affiliation>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne</wicri:regionArea>
<placeName>
<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Marshall, John C" sort="Marshall, John C" uniqKey="Marshall J" first="John C" last="Marshall">John C. Marshall</name>
<affiliation wicri:level="4">
<nlm:affiliation>Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto</wicri:regionArea>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
<orgName type="university">Université de Toronto</orgName>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Trials</title>
<idno type="eISSN">1745-6215</idno>
<imprint>
<date when="2020" type="published">2020</date>
</imprint>
</series>
</biblStruct>
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<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Adrenal Cortex Hormones (therapeutic use)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Coronavirus Infections (drug therapy)</term>
<term>Critical Illness (MeSH)</term>
<term>Dexamethasone (therapeutic use)</term>
<term>Glucocorticoids (therapeutic use)</term>
<term>Humans (MeSH)</term>
<term>Hydrocortisone (therapeutic use)</term>
<term>Methylprednisolone (therapeutic use)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (drug therapy)</term>
<term>Prospective Studies (MeSH)</term>
<term>Randomized Controlled Trials as Topic (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Betacoronavirus (MeSH)</term>
<term>Dexaméthasone (usage thérapeutique)</term>
<term>Essais contrôlés randomisés comme sujet (MeSH)</term>
<term>Glucocorticoïdes (usage thérapeutique)</term>
<term>Hormones corticosurrénaliennes (usage thérapeutique)</term>
<term>Humains (MeSH)</term>
<term>Hydrocortisone (usage thérapeutique)</term>
<term>Infections à coronavirus (traitement médicamenteux)</term>
<term>Maladie grave (MeSH)</term>
<term>Méthylprednisolone (usage thérapeutique)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (traitement médicamenteux)</term>
<term>Études prospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>Adrenal Cortex Hormones</term>
<term>Dexamethasone</term>
<term>Glucocorticoids</term>
<term>Hydrocortisone</term>
<term>Methylprednisolone</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr">
<term>Dexaméthasone</term>
<term>Glucocorticoïdes</term>
<term>Hormones corticosurrénaliennes</term>
<term>Hydrocortisone</term>
<term>Méthylprednisolone</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Betacoronavirus</term>
<term>Critical Illness</term>
<term>Humans</term>
<term>Pandemics</term>
<term>Prospective Studies</term>
<term>Randomized Controlled Trials as Topic</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Betacoronavirus</term>
<term>Essais contrôlés randomisés comme sujet</term>
<term>Humains</term>
<term>Maladie grave</term>
<term>Pandémies</term>
<term>Études prospectives</term>
</keywords>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVES</b>
</p>
<p>Primary objective: To estimate the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization. Secondary objectives: To examine whether the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization varies between subgroups related to treatment characteristics, disease severity at the time of randomization, patient characteristics, or risk of bias. To examine the effect of corticosteroids compared with usual care or placebo on serious adverse events.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>STUDY DESIGN</b>
</p>
<p>Prospective meta-analysis of randomized controlled trials. Both placebo-controlled and open-label trials are eligible.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PARTICIPANTS</b>
</p>
<p>Hospitalised, critically ill patients with suspected or confirmed COVID-19.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERVENTION AND COMPARATOR</b>
</p>
<p>Intervention groups will have received therapeutic doses of a steroid (dexamethasone, hydrocortisone or methylprednisolone) with IV or oral administration immediately after randomization. The comparator groups will have received standard of care or usual care or placebo.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>MAIN OUTCOME</b>
</p>
<p>All-cause mortality up to 28 days after randomization.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SEARCH METHODS</b>
</p>
<p>Systematic searching of clinicaltrials.gov , EudraCT, the WHO ISRCTN registry, and the Chinese clinical trials registry. Additionally, research and WHO networks will be asked for relevant trials.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RISK OF BIAS ASSESSMENTS</b>
</p>
<p>These will be based on the Cochrane RoB 2 tool, and will use structured information provided by the trial investigators on a form designed for this prospective meta-analysis. We will use GRADE to assess the certainty of the evidence.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>STATISTICAL ANALYSES</b>
</p>
<p>Trial investigators will provide data on the numbers of participants who did and did not experience each outcome according to intervention group, overall and in specified subgroups. We will conduct fixed-effect (primary analysis) and random-effects (Paule-Mandel estimate of heterogeneity and Hartung-Knapp adjustment) meta-analyses. We will quantify inconsistency in effects between trials using I</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PROSPERO REGISTRATION NUMBER</b>
</p>
<p>CRD42020197242 FULL PROTOCOL: The full protocol for this prospective meta-analysis is attached as an additional file, accessible from the Trials website (Additional file 1). To expedite dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol for the systematic review.</p>
</div>
</front>
</TEI>
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<MedlineCitation Status="MEDLINE" Owner="NLM">
<PMID Version="1">32831155</PMID>
<DateCompleted>
<Year>2020</Year>
<Month>09</Month>
<Day>03</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>09</Month>
<Day>13</Day>
</DateRevised>
<Article PubModel="Electronic">
<Journal>
<ISSN IssnType="Electronic">1745-6215</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>21</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2020</Year>
<Month>Aug</Month>
<Day>24</Day>
</PubDate>
</JournalIssue>
<Title>Trials</Title>
<ISOAbbreviation>Trials</ISOAbbreviation>
</Journal>
<ArticleTitle>Corticosteroid therapy for critically ill patients with COVID-19: A structured summary of a study protocol for a prospective meta-analysis of randomized trials.</ArticleTitle>
<Pagination>
<MedlinePgn>734</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1186/s13063-020-04641-3</ELocationID>
<Abstract>
<AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">Primary objective: To estimate the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization. Secondary objectives: To examine whether the effect of corticosteroids compared with usual care or placebo on mortality up to 28 days after randomization varies between subgroups related to treatment characteristics, disease severity at the time of randomization, patient characteristics, or risk of bias. To examine the effect of corticosteroids compared with usual care or placebo on serious adverse events.</AbstractText>
<AbstractText Label="STUDY DESIGN" NlmCategory="METHODS">Prospective meta-analysis of randomized controlled trials. Both placebo-controlled and open-label trials are eligible.</AbstractText>
<AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">Hospitalised, critically ill patients with suspected or confirmed COVID-19.</AbstractText>
<AbstractText Label="INTERVENTION AND COMPARATOR" NlmCategory="UNASSIGNED">Intervention groups will have received therapeutic doses of a steroid (dexamethasone, hydrocortisone or methylprednisolone) with IV or oral administration immediately after randomization. The comparator groups will have received standard of care or usual care or placebo.</AbstractText>
<AbstractText Label="MAIN OUTCOME" NlmCategory="RESULTS">All-cause mortality up to 28 days after randomization.</AbstractText>
<AbstractText Label="SEARCH METHODS" NlmCategory="METHODS">Systematic searching of clinicaltrials.gov , EudraCT, the WHO ISRCTN registry, and the Chinese clinical trials registry. Additionally, research and WHO networks will be asked for relevant trials.</AbstractText>
<AbstractText Label="RISK OF BIAS ASSESSMENTS" NlmCategory="UNASSIGNED">These will be based on the Cochrane RoB 2 tool, and will use structured information provided by the trial investigators on a form designed for this prospective meta-analysis. We will use GRADE to assess the certainty of the evidence.</AbstractText>
<AbstractText Label="STATISTICAL ANALYSES" NlmCategory="METHODS">Trial investigators will provide data on the numbers of participants who did and did not experience each outcome according to intervention group, overall and in specified subgroups. We will conduct fixed-effect (primary analysis) and random-effects (Paule-Mandel estimate of heterogeneity and Hartung-Knapp adjustment) meta-analyses. We will quantify inconsistency in effects between trials using I
<sup>2</sup>
statistics. Evidence for subgroup effects will be quantified by ratios of odds ratios comparing effects in the subgroups, and corresponding interaction p-values. Comparisons between subgroups defined by trial characteristics will be made using random-effects meta-regression. Comparisons between subgroups defined by patient characteristics will be made by estimating trial-specific ratios of odds ratios comparing intervention effects between subgroups then combining these using random-effects meta-analysis. Steroid interventions will be classified as high or low dose according to whether the dose is greater or less than or equal to 400 mg hydrocortisone per day or equivalent. We will use network meta-analysis methods to make comparisons between the effects of high and low dose steroid interventions (because one trial randomized participants to both low and high dose steroid arms).</AbstractText>
<AbstractText Label="PROSPERO REGISTRATION NUMBER" NlmCategory="UNASSIGNED">CRD42020197242 FULL PROTOCOL: The full protocol for this prospective meta-analysis is attached as an additional file, accessible from the Trials website (Additional file 1). To expedite dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol for the systematic review.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Sterne</LastName>
<ForeName>Jonathan A C</ForeName>
<Initials>JAC</Initials>
<Identifier Source="ORCID">http://orcid.org/0000-0001-8496-6053</Identifier>
<AffiliationInfo>
<Affiliation>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. jonathan.sterne@bristol.ac.uk.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>NIHR Bristol Biomedical Research Centre, Bristol, UK. jonathan.sterne@bristol.ac.uk.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Diaz</LastName>
<ForeName>Janet</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Clinical Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Villar</LastName>
<ForeName>Jesús</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Research Unit, Hospital Universitario Dr. Negrin Las Palmas de Gran Canaria, Las Palmas, Spain.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Murthy</LastName>
<ForeName>Srinivas</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Department of Pediatrics, University of British Columbia, Vancouver, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Slutsky</LastName>
<ForeName>Arthur S</ForeName>
<Initials>AS</Initials>
<AffiliationInfo>
<Affiliation>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Perner</LastName>
<ForeName>Anders</ForeName>
<Initials>A</Initials>
<AffiliationInfo>
<Affiliation>Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Jüni</LastName>
<ForeName>Peter</ForeName>
<Initials>P</Initials>
<AffiliationInfo>
<Affiliation>Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Angus</LastName>
<ForeName>Derek C</ForeName>
<Initials>DC</Initials>
<AffiliationInfo>
<Affiliation>Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Annane</LastName>
<ForeName>Djillali</ForeName>
<Initials>D</Initials>
<AffiliationInfo>
<Affiliation>Department of Intensive Care, Raymond Poincaré Hospital (APHP), School of Medicine Simone Veil, University Paris Saclay -UVSQ, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Azevedo</LastName>
<ForeName>Luciano Cesar Pontes</ForeName>
<Initials>LCP</Initials>
<AffiliationInfo>
<Affiliation>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Du</LastName>
<ForeName>Bin</ForeName>
<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>Peking Union Medical College Hospital, Beijing, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Dequin</LastName>
<ForeName>Pierre-Francois</ForeName>
<Initials>PF</Initials>
<AffiliationInfo>
<Affiliation>Médecine Intensive - Réanimation, INSERM CIC1415, CHRU de Tours, Tours, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>CRICS-TriGGERSep network, Centre d'Etude des Pathologies Respiratoires, Université de Tours, Tours, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Gordon</LastName>
<ForeName>Anthony C</ForeName>
<Initials>AC</Initials>
<AffiliationInfo>
<Affiliation>Division of Anaesthetics, Pain Medicine & Intensive Care, Imperial College London, London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Green</LastName>
<ForeName>Cameron</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Higgins</LastName>
<ForeName>Julian P T</ForeName>
<Initials>JPT</Initials>
<AffiliationInfo>
<Affiliation>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>NIHR Bristol Biomedical Research Centre, Bristol, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Horby</LastName>
<ForeName>Peter</ForeName>
<Initials>P</Initials>
<AffiliationInfo>
<Affiliation>Nuffield Department of Medicine, University of Oxford, Oxford, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Landray</LastName>
<ForeName>Martin J</ForeName>
<Initials>MJ</Initials>
<AffiliationInfo>
<Affiliation>Nuffield Department of Population Health, University of Oxford, Oxford, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>MRC Population Health Research Unit, University of Oxford, Oxford, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lapadula</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Le Gouge</LastName>
<ForeName>Amelie</ForeName>
<Initials>A</Initials>
<AffiliationInfo>
<Affiliation>CIC INSERM 1415 - CHRU de Tours, Hôpital Bretonneau, Tours, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Leclerc</LastName>
<ForeName>Marie</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>Délégation à la Recherche Clinique et à l'Innovation, CHRU de Tours, Tours, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Savović</LastName>
<ForeName>Jelena</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>NIHR Applied Research Collaboration (ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Tomazini</LastName>
<ForeName>Bruno</ForeName>
<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>Critical Care and Emergency Medicine, Hospital Sirio Libanês, São Paulo, Brazil.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Venkatesh</LastName>
<ForeName>Balasubramanian</ForeName>
<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>George Institute for Global Health, University of New South Wales, Sydney, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Webb</LastName>
<ForeName>Steve</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Marshall</LastName>
<ForeName>John C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo>
<Affiliation>Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<CollectiveName>WHO COVID-19 Clinical Management and Characterization Working Group</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>001</GrantID>
<Acronym>WHO_</Acronym>
<Agency>World Health Organization</Agency>
<Country>International</Country>
</Grant>
</GrantList>
<PublicationTypeList>
<PublicationType UI="D016422">Letter</PublicationType>
<PublicationType UI="D017418">Meta-Analysis</PublicationType>
<PublicationType UI="D000078182">Systematic Review</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic">
<Year>2020</Year>
<Month>08</Month>
<Day>24</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo>
<Country>England</Country>
<MedlineTA>Trials</MedlineTA>
<NlmUniqueID>101263253</NlmUniqueID>
<ISSNLinking>1745-6215</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000305">Adrenal Cortex Hormones</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D005938">Glucocorticoids</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>7S5I7G3JQL</RegistryNumber>
<NameOfSubstance UI="D003907">Dexamethasone</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>WI4X0X7BPJ</RegistryNumber>
<NameOfSubstance UI="D006854">Hydrocortisone</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>X4W7ZR7023</RegistryNumber>
<NameOfSubstance UI="D008775">Methylprednisolone</NameOfSubstance>
</Chemical>
</ChemicalList>
<SupplMeshList>
<SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
<SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName>
<SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D000305" MajorTopicYN="N">Adrenal Cortex Hormones</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D003907" MajorTopicYN="N">Dexamethasone</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005938" MajorTopicYN="N">Glucocorticoids</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006854" MajorTopicYN="N">Hydrocortisone</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008775" MajorTopicYN="N">Methylprednisolone</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">Corticosteroid</Keyword>
<Keyword MajorTopicYN="N">Dexamethasone</Keyword>
<Keyword MajorTopicYN="N">Hydrocortisone</Keyword>
<Keyword MajorTopicYN="N">Meta-analysis</Keyword>
<Keyword MajorTopicYN="N">Methylprednisolone</Keyword>
<Keyword MajorTopicYN="N">Mortality</Keyword>
<Keyword MajorTopicYN="N">Randomised controlled trial</Keyword>
<Keyword MajorTopicYN="N">Systematic Review</Keyword>
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<History>
<PubMedPubDate PubStatus="received">
<Year>2020</Year>
<Month>07</Month>
<Day>11</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2020</Year>
<Month>07</Month>
<Day>29</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2020</Year>
<Month>8</Month>
<Day>25</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed">
<Year>2020</Year>
<Month>8</Month>
<Day>25</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="medline">
<Year>2020</Year>
<Month>9</Month>
<Day>4</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<ArticleId IdType="doi">10.1186/s13063-020-04641-3</ArticleId>
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<li>Brésil</li>
<li>Canada</li>
<li>Danemark</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Royaume-Uni</li>
<li>République populaire de Chine</li>
<li>Suisse</li>
<li>États-Unis</li>
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<li>Centre-Val de Loire</li>
<li>Colombie-Britannique</li>
<li>Communauté de Madrid</li>
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<li>Hovedstaden</li>
<li>Nouvelle-Galles du Sud</li>
<li>Ontario</li>
<li>Oxfordshire</li>
<li>Pennsylvanie</li>
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<li>Victoria (État)</li>
<li>État de São Paulo</li>
<li>Île-de-France</li>
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<li>Vancouver</li>
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<li>Université de Tours</li>
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<name sortKey="Horby, Peter" sort="Horby, Peter" uniqKey="Horby P" first="Peter" last="Horby">Peter Horby</name>
<name sortKey="Landray, Martin J" sort="Landray, Martin J" uniqKey="Landray M" first="Martin J" last="Landray">Martin J. Landray</name>
<name sortKey="Landray, Martin J" sort="Landray, Martin J" uniqKey="Landray M" first="Martin J" last="Landray">Martin J. Landray</name>
<name sortKey="Landray, Martin J" sort="Landray, Martin J" uniqKey="Landray M" first="Martin J" last="Landray">Martin J. Landray</name>
<name sortKey="Savovi, Jelena" sort="Savovi, Jelena" uniqKey="Savovi J" first="Jelena" last="Savovi">Jelena Savovi</name>
<name sortKey="Savovi, Jelena" sort="Savovi, Jelena" uniqKey="Savovi J" first="Jelena" last="Savovi">Jelena Savovi</name>
<name sortKey="Sterne, Jonathan A C" sort="Sterne, Jonathan A C" uniqKey="Sterne J" first="Jonathan A C" last="Sterne">Jonathan A C. Sterne</name>
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<name sortKey="Villar, Jesus" sort="Villar, Jesus" uniqKey="Villar J" first="Jesús" last="Villar">Jesús Villar</name>
</noRegion>
<name sortKey="Villar, Jesus" sort="Villar, Jesus" uniqKey="Villar J" first="Jesús" last="Villar">Jesús Villar</name>
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<name sortKey="Murthy, Srinivas" sort="Murthy, Srinivas" uniqKey="Murthy S" first="Srinivas" last="Murthy">Srinivas Murthy</name>
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<name sortKey="Slutsky, Arthur S" sort="Slutsky, Arthur S" uniqKey="Slutsky A" first="Arthur S" last="Slutsky">Arthur S. Slutsky</name>
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<name sortKey="Perner, Anders" sort="Perner, Anders" uniqKey="Perner A" first="Anders" last="Perner">Anders Perner</name>
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<name sortKey="Angus, Derek C" sort="Angus, Derek C" uniqKey="Angus D" first="Derek C" last="Angus">Derek C. Angus</name>
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<country name="France">
<region name="Île-de-France">
<name sortKey="Annane, Djillali" sort="Annane, Djillali" uniqKey="Annane D" first="Djillali" last="Annane">Djillali Annane</name>
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<name sortKey="Dequin, Pierre Francois" sort="Dequin, Pierre Francois" uniqKey="Dequin P" first="Pierre-Francois" last="Dequin">Pierre-Francois Dequin</name>
<name sortKey="Dequin, Pierre Francois" sort="Dequin, Pierre Francois" uniqKey="Dequin P" first="Pierre-Francois" last="Dequin">Pierre-Francois Dequin</name>
<name sortKey="Le Gouge, Amelie" sort="Le Gouge, Amelie" uniqKey="Le Gouge A" first="Amelie" last="Le Gouge">Amelie Le Gouge</name>
<name sortKey="Leclerc, Marie" sort="Leclerc, Marie" uniqKey="Leclerc M" first="Marie" last="Leclerc">Marie Leclerc</name>
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<name sortKey="Azevedo, Luciano Cesar Pontes" sort="Azevedo, Luciano Cesar Pontes" uniqKey="Azevedo L" first="Luciano Cesar Pontes" last="Azevedo">Luciano Cesar Pontes Azevedo</name>
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<name sortKey="Tomazini, Bruno" sort="Tomazini, Bruno" uniqKey="Tomazini B" first="Bruno" last="Tomazini">Bruno Tomazini</name>
</country>
<country name="République populaire de Chine">
<noRegion>
<name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name>
</noRegion>
</country>
<country name="Australie">
<region name="Victoria (État)">
<name sortKey="Green, Cameron" sort="Green, Cameron" uniqKey="Green C" first="Cameron" last="Green">Cameron Green</name>
</region>
<name sortKey="Venkatesh, Balasubramanian" sort="Venkatesh, Balasubramanian" uniqKey="Venkatesh B" first="Balasubramanian" last="Venkatesh">Balasubramanian Venkatesh</name>
<name sortKey="Webb, Steve" sort="Webb, Steve" uniqKey="Webb S" first="Steve" last="Webb">Steve Webb</name>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Lapadula, Giuseppe" sort="Lapadula, Giuseppe" uniqKey="Lapadula G" first="Giuseppe" last="Lapadula">Giuseppe Lapadula</name>
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</country>
</tree>
</affiliations>
</record>

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Data generation: Tue Oct 6 23:31:36 2020. Site generation: Fri Feb 12 22:48:37 2021