Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis
Background: Most studies have reported that corticosteroid therapy adversely influences influenza-related outcomes. Methods: Electronic databases were searched from inception to March 2013 for experimental and observational studies investigating systemic corticosteroid therapy for presumed influe...
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| Format: | Article |
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Oxford University Press
2015
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| Online Access: | https://eprints.nottingham.ac.uk/41664/ |
| _version_ | 1848796326386466816 |
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| author | Rodrigo, Chamira Leonardi-Bee, Jo Nguyen-Van-Tam, Jonathan S. Lim, Wei Shen |
| author_facet | Rodrigo, Chamira Leonardi-Bee, Jo Nguyen-Van-Tam, Jonathan S. Lim, Wei Shen |
| author_sort | Rodrigo, Chamira |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Most studies have reported that corticosteroid therapy adversely influences influenza-related outcomes.
Methods: Electronic databases were searched from inception to March 2013 for experimental and observational studies investigating systemic corticosteroid therapy for presumed influenza-associated complications. Meta-analysis of Observational Studies in Epidemiology guidelines were adopted. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects models, and heterogeneity was assessed using the I2 statistic. Quality of evidence was assessed using the Grading Assessment, Development, and Evaluation system.
Results: We identified 16 eligible studies (3039 individuals), all of which were observational; 10 (1497 individuals) were included in the meta-analysis of mortality, of which 9 studied patients with 2009 pandemic influenza A virus subtype H1N1. Risk of bias was greatest in the comparability domain of the Newcastle–Ottawa scale, consistent with potential confounding by indication, and data specific to mortality were of low quality. Meta-analysis found an increased odds of mortality (OR, 2.12; 95% CI, 1.36–3.29) associated with corticosteroid therapy. Subgroup analysis of adjusted estimates from 4 studies with very low statistical heterogeneity found a similar association (OR, 2.58; 95% CI, 1.39–4.79).
Conclusions: No completed clinical trials were identified. Evidence from observational studies, with important limitations, suggests that corticosteroid therapy for presumed influenza-associated complications is associated with increased mortality. |
| first_indexed | 2025-11-14T19:46:12Z |
| format | Article |
| id | nottingham-41664 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:46:12Z |
| publishDate | 2015 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-416642020-05-04T17:13:06Z https://eprints.nottingham.ac.uk/41664/ Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis Rodrigo, Chamira Leonardi-Bee, Jo Nguyen-Van-Tam, Jonathan S. Lim, Wei Shen Background: Most studies have reported that corticosteroid therapy adversely influences influenza-related outcomes. Methods: Electronic databases were searched from inception to March 2013 for experimental and observational studies investigating systemic corticosteroid therapy for presumed influenza-associated complications. Meta-analysis of Observational Studies in Epidemiology guidelines were adopted. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random-effects models, and heterogeneity was assessed using the I2 statistic. Quality of evidence was assessed using the Grading Assessment, Development, and Evaluation system. Results: We identified 16 eligible studies (3039 individuals), all of which were observational; 10 (1497 individuals) were included in the meta-analysis of mortality, of which 9 studied patients with 2009 pandemic influenza A virus subtype H1N1. Risk of bias was greatest in the comparability domain of the Newcastle–Ottawa scale, consistent with potential confounding by indication, and data specific to mortality were of low quality. Meta-analysis found an increased odds of mortality (OR, 2.12; 95% CI, 1.36–3.29) associated with corticosteroid therapy. Subgroup analysis of adjusted estimates from 4 studies with very low statistical heterogeneity found a similar association (OR, 2.58; 95% CI, 1.39–4.79). Conclusions: No completed clinical trials were identified. Evidence from observational studies, with important limitations, suggests that corticosteroid therapy for presumed influenza-associated complications is associated with increased mortality. Oxford University Press 2015-07-15 Article PeerReviewed Rodrigo, Chamira, Leonardi-Bee, Jo, Nguyen-Van-Tam, Jonathan S. and Lim, Wei Shen (2015) Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis. Journal of Infectious Diseases, 212 (2). pp. 183-194. ISSN 1537-6613 influenza; corticosteroid https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiu645 doi:10.1093/infdis/jiu645 doi:10.1093/infdis/jiu645 |
| spellingShingle | influenza; corticosteroid Rodrigo, Chamira Leonardi-Bee, Jo Nguyen-Van-Tam, Jonathan S. Lim, Wei Shen Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title | Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title_full | Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title_fullStr | Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title_short | Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| title_sort | effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis |
| topic | influenza; corticosteroid |
| url | https://eprints.nottingham.ac.uk/41664/ https://eprints.nottingham.ac.uk/41664/ https://eprints.nottingham.ac.uk/41664/ |