Corticosteroids for reducing mortality and mechanical ventilation

A living systematic review and network meta-analysis published in the British Medical Journal has analysed drug treatments used for COVID-19 (Siemieniuk et al, 2020). The objective was to compare the effects of these treatments, using data sources such as the World Health Organization (WHO) COVID-19 database, which contains a comprehensive multilingual source of global COVID-19 literature, including dates up to 3 December 2020, alongside six Chinese databases up to 12 November 2020.

The study involved a selection of randomised clinical trials in which people with suspected, probable or confirmed COVID-19 were allocated at random to drug treatment, standard care, or placebo. Pairs of reviewers then independently screened potentially eligible articles. Following duplicate data abstraction, a Bayesian network meta-analysis was conducted. Risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development and evaluation (GRADE) approach. The team classified interventions for each outcome into groups from the most to the least beneficial or harmful, following GRADE guidance (Siemieniuk et al, 2020).