Imperial College London
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Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{WHO:2020:10.1001/jama.2020.17023,
author = {WHO, Rapid Evidence Appraisal for COVID-19 Therapies REACT Working Group and Sterne, JAC and Murthy, S and Diaz, JV and Slutsky, AS and Villar, J and Angus, DC and Annane, D and Azevedo, LCP and Berwanger, O and Cavalcanti, AB and Dequin, P-F and Du, B and Emberson, J and Fisher, D and Giraudeau, B and Gordon, AC and Granholm, A and Green, C and Haynes, R and Heming, N and Higgins, JPT and Horby, P and Jüni, P and Landray, MJ and Le, Gouge A and Leclerc, M and Lim, WS and Machado, FR and McArthur, C and Meziani, F and Møller, MH and Perner, A and Petersen, MW and Savovic, J and Tomazini, B and Veiga, VC and Webb, S and Marshall, JC},
doi = {10.1001/jama.2020.17023},
journal = {JAMA},
pages = {1330--1341},
title = {Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis.},
url = {http://dx.doi.org/10.1001/jama.2020.17023},
volume = {324},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance: Effective therapies for patients with coronavirus disease 2019 (COVID-19) are needed, and clinical trial data have demonstrated that low-dose dexamethasone reduced mortality in hospitalized patients with COVID-19 who required respiratory support. Objective: To estimate the association between administration of corticosteroids compared with usual care or placebo and 28-day all-cause mortality. Design, Setting, and Participants: Prospective meta-analysis that pooled data from 7 randomized clinical trials that evaluated the efficacy of corticosteroids in 1703 critically ill patients with COVID-19. The trials were conducted in 12 countries from February 26, 2020, to June 9, 2020, and the date of final follow-up was July 6, 2020. Pooled data were aggregated from the individual trials, overall, and in predefined subgroups. Risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I2 statistic. The primary analysis was an inverse variance-weighted fixed-effect meta-analysis of overall mortality, with the association between the intervention and mortality quantified using odds ratios (ORs). Random-effects meta-analyses also were conducted (with the Paule-Mandel estimate of heterogeneity and the Hartung-Knapp adjustment) and an inverse variance-weighted fixed-effect analysis using risk ratios. Exposures: Patients had been randomized to receive systemic dexamethasone, hydrocortisone, or methylprednisolone (678 patients) or to receive usual care or placebo (1025 patients). Main Outcomes and Measures: The primary outcome measure was all-cause mortality at 28 days after randomization. A secondary outcome was investigator-defined serious adverse events. Results: A total of 1703 patients (median age, 60 years [interquartile range, 52-68 years]; 488 [29%] women) were included in the analysis. Risk of bias was assessed as "low" for 6 of the 7 mortality results and as "some concerns&q
AU  - WHO,Rapid Evidence Appraisal for COVID-19 Therapies REACT Working Group
AU  - Sterne,JAC
AU  - Murthy,S
AU  - Diaz,JV
AU  - Slutsky,AS
AU  - Villar,J
AU  - Angus,DC
AU  - Annane,D
AU  - Azevedo,LCP
AU  - Berwanger,O
AU  - Cavalcanti,AB
AU  - Dequin,P-F
AU  - Du,B
AU  - Emberson,J
AU  - Fisher,D
AU  - Giraudeau,B
AU  - Gordon,AC
AU  - Granholm,A
AU  - Green,C
AU  - Haynes,R
AU  - Heming,N
AU  - Higgins,JPT
AU  - Horby,P
AU  - Jüni,P
AU  - Landray,MJ
AU  - Le,Gouge A
AU  - Leclerc,M
AU  - Lim,WS
AU  - Machado,FR
AU  - McArthur,C
AU  - Meziani,F
AU  - Møller,MH
AU  - Perner,A
AU  - Petersen,MW
AU  - Savovic,J
AU  - Tomazini,B
AU  - Veiga,VC
AU  - Webb,S
AU  - Marshall,JC
DO  - 10.1001/jama.2020.17023
EP  - 1341
PY  - 2020///
SP  - 1330
TI  - Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis.
T2  - JAMA
UR  - http://dx.doi.org/10.1001/jama.2020.17023
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32876694
VL  - 324
ER  -
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