The pandemic is gone but its consequences are here to stay: avascular necrosis following corticosteroids administration for severe COVID-19

Table 4 Clinical investigations exploring the time-limited high-dose CCS administration in patients with COVID-19 infection receiving oxygen therapy or invasive mechanical ventilation

Author, year	Country	Journal	Study Design	Sample Size	Treatment
Galvez-Romero et al. [59]	Mexico	J Intern Med	Open-label, non-RCT	209	Methylprednisolone or Prednisone
Fernández-Cruz et al. [60]	Spain	Antimicrob Agents Chemother	Retrospective, controlled	463	Methylprednisolone
Horby et al. [61]	United Kingdom	N Engl J Med	Prospective, controlled, open-label	6425	Dexamethasone
Keller et al. [62]	USA	J Hosp Med	Retrospective	1806	Glucocorticoids (not specified)
Mikulska et al. [63]	Italy	PLoS One	Retrospective	196	Methylprednisolone
Murohashi et al. [64]	Japan	Respir Investig	Retrospective	11	Methylprednisolone
Obata et al. [65]	America	Jpn J Infect Dis Action Epub	Retrospective	226	Dexamethasone, Prednisolone
Rana et al. [66]	Pakistan	Cureus	Retrospective	60	Dexamethasone or Methylprednisolone
Rodríguez-Molinero et al. [67]	Spain	Med Clin (Barc)	Retrospective	418	Methylprednisolone
Spagnuolo et al. [68]	Italy	Sci Rep	Retrospective	280	Methylprednisolone
Xiaofan Lu et al. [69]	China	N Engl J Med	Retrospective	244	Hydrocortisone
Yan et al. [70]	China	Biomed Pharmacother	Retrospective	308	Methylprednisolone
Zhu et al. [71]	China	World J Clin Cases	Retrospective	102	Methylprednisolone

The analysis included 13 articles for a total of 10,748 patients treated with steroids for COVID-19. Eleven studies were retrospective, one open-label non-RCT, and one prospective controlled, open-label trial. The steroids used varied from Dexamethasone, Prednisone, or Methylprednisolone. No case of AVN among time-limited high-dose CCS-treated patients was reported

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