Cochrane · systematic review · CD010406

Corticosteroids as adjunctive therapy in the treatment of influenza

Lansbury, L, Rodrigo, C, Leonardi‐Bee, J, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library

Acute Respiratory Infections2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 100%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Corticosteroid therapy compared to no corticosteroid therapy in the treatment of influenza

Population: individuals with influenza

CD010406.PUB3 (current) · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Number of deaths at 30 days following admission (30‐day mortality)a Corticosteroid therapy vs no corticosteroid therapy	OR 3.9 [2.31, 6.6]	21 studies · 9536 participants	Very low Downgraded: risk of bias, inconsistency
Rate of admission to intensive care units Corticosteroid therapy vs no corticosteroid therapy	OR 5.13 [4.26, 6.17]	1 study · 2141 participants	Very low Downgraded: risk of bias
Number and nature of adverse events secondary to corticosteroid use (hospital‐acquired infection) Corticosteroid therapy vs no corticosteroid therapy	OR 2.74 [1.51, 4.95]	7 studies · 6114 participants	Very low Downgraded: risk of bias, inconsistency
Proportion of participants requiring mechanical ventilation Corticosteroid therapy vs no corticosteroid therapy	no estimate extracted	4 studies · 4364 participants	Very low Downgraded: risk of bias, inconsistency

Effect of corticosteroid therapy on influenza‐related outcomes

Population: individuals with influenza

CD010406.PUB2 · 4 questions

Outcome	Effect	Evidence	Status / GRADE
Mortality	OR 3.06 [1.58, 5.92]	13 studies · 1915 participants	Very low Downgraded: risk of bias, inconsistency
Hospital‐acquired infection	no estimate extracted	3 studies · 619 participants	Very low Downgraded: risk of bias, inconsistency
Critical illness (composite outcome including death and intensive care unit admission)	no estimate extracted	2 studies · 322 participants	Very low Downgraded: risk of bias, inconsistency
Mechanical ventilation	no estimate extracted	2 studies · 377 participants	Very low Downgraded: risk of bias, inconsistency