Effectiveness of Corticosteroids in the Treatment of Pneumonia: A Systematic Review and Meta-Analysis
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Abstract
Pneumonia remains a major global health burden, contributing significantly to hospitalizations and mortality. In recent years, the use of corticosteroids as an adjunctive therapy has gained attention due to their anti-inflammatory effects, particularly in cases marked by an exaggerated immune response. This systematic review and meta-analysis aimed to assess the overall effectiveness of corticosteroids in the management of pneumonia, based on ten selected clinical trials published between 2005 and 2024. The studies included a diverse range of patients with community-acquired pneumonia (CAP), COVID-19-related pneumonia, and varying levels of disease severity. Corticosteroids such as hydrocortisone, dexamethasone, and prednisone were evaluated across multiple outcomes, including mortality, treatment failure, length of hospital stay, ICU admission, and adverse effects. Findings showed that corticosteroid use may be associated with a reduction in treatment failure and shorter hospital stays, particularly in patients with severe pneumonia or high inflammatory markers. Mortality benefits were more consistent in studies involving COVID-19-related pneumonia or severe CAP. However, variations in corticosteroid dosage, treatment duration, and study methodologies contributed to heterogeneity across the included trials. Although some studies reported increased risk of hyperglycemia and secondary infections, the overall safety profile was acceptable. These results suggest that corticosteroids can be beneficial in selected pneumonia populations, especially when inflammation plays a critical role in disease progression. Nonetheless, standardization in treatment protocols and further high-quality randomized trials are needed to refine clinical recommendations and ensure optimal patient outcomes.
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