The use of intravenous corticosteroids in severe patients with community-acquired pneumonia (CAP) - A systematic review

• Grant number: 23/09069-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2023
• End date: June 30, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Suzana Erico Tanni
• Grantee: Fernanda Bley Cardoso
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Community-acquired pneumonia (CAP) is an acute respiratory infection that can be caused by a variety of pathogens, including bacteria, viruses and, less frequently, fungi. It is defined as an infection acquired outside the hospital environment, or that manifests itself within 48 hours after hospitalization. In severe cases, it can lead to respiratory failure and death. The use of intravenous corticosteroids has been proposed as an adjuvant therapy in the treatment of critically ill patients with CAP, due to their anti-inflammatory and immunomodulatory action. However, the safety and efficacy of the use of intravenous corticosteroids in patients with severe CAP are still not fully understood, which creates uncertainties when making changes in the medical care. Objective: This systematic review with meta-analysis aims to evaluate the effect of the use of intravenous corticosteroids in severe adult patients with CAP. Methods: A systematic review of the literature with meta-analysis according to the protocol (PRISMA) will be carried out. The study protocol will be based on the PICO question, in which the study population will be patients with severe CAP, intervention will be the use of corticosteroids, the comparator will be the standard treatment, and the outcomes will be hospitalization time, use of mechanical ventilation, time of use mechanical ventilation, secondary infection and mortality. Subgroups of patients who had diagnoses confirmed by bacterial and viral agents will be evaluated. Inclusion criteria will be randomized clinical trials, with no language or date period restriction. The risk of bias will be assessed with the Cochrane risk of bias. Two independent investigators will perform the data extraction and inclusion. The quality of evidence will be graded according to the GRADE criteria. Expected Results: Demonstrate the effectiveness of using intravenous corticosteroids in patients with severe CAP requiring mechanical ventilation, length of hospital internment and death.