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.
KEYWORDS (MeSH terms):
Dexamethasone; COVID-19; SARS-CoV-2; Meta-analysis [publication type]; Pulmonary medicine
AUTHORS’ KEYWORDS:
Coronavirus pandemic; Drug repurposing; Respiratory medicine; Clinical trials
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