| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
Outcome not yet measured or reported
|
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D28 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 0.61
(0.35 - 1.05) |
91 fewer per 1000
(from 151 fewer to 12 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding deviation from intended intervention, missing data, and selection of the reported results Inconsistency: Not serious Indirectness: Serious
studies from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 2 trials
Dastenae ZH, 2022; Ranjbar K, 2021
236 participants
|
|
Methylprednisolone
142 per 1,000
(81 - 244) |
Dexamethasone
233
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR: 0.98
(0.06 - 15.19) |
0 fewer per 1000
(from 20 fewer to 308 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
single study from a single institution therefore results in this population might not be generalizable to other settings Imprecision: Serious
due to wide confidence interval consistent with the possibility for no effect/trivial effect and the possibility for harm
|
| 1 trials
Ranjbar K, 2021
93 participants
|
|
Methylprednisolone
21 per 1,000
(1 - 330) |
Dexamethasone
22
per 1,000 |
|
Serious adverse events
|
RR:
( - ) |
Zero events in both groups
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Very serious
single study from a single institution therefore results in this population might not be generalizable to other settings Imprecision: Very serious
no events in both groups
|
| 1 trials
Ranjbar K, 2021
93 participants
|
|
Methylprednisolone
0 per 1,000
( - ) |
Dexamethasone
0
per 1,000 |
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
