The University of Toledo Translation Journal of Medical Sciences Pulmonology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 Pulse Versus Nonpulse Steroid Regimens in Patients with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis Elizabeth Borchers1*, Waleed Khokher2, Azizullah Beran2, Saffa Iftikhar2, Saif-Eddin Malhas2, Omar Srour2, Mohammed Mhanna2, Sapan Bhuta2, Dipen Patel2, Nithin Kesireddy2, Cameron Burmeister2, Ragheb Assaly1, Fadi Safi2 1Division of Pulmonology and Critical Care Medicine, Department of Medicine, The University of Toledo, Toledo, OH 43614 2Division of Internal Medicine, Department of Medicine, The University of Toledo, Toledo, OH 43614 *Corresponding author: Elizabeth.Borchers@rockets.utoledo.edu Published: 05 May 2023 Background: Systemic steroids are associated with reduced mortality in hypoxic patients with COVID- 19. However, there is no consensus on the doses of steroid therapy in these patients. Several studies showed that pulse dose steroids (PDS) could reduce the progression of COVID-19 pneumonia. However, data regarding the role of PDS in COVID-19 is still unclear. Therefore, we performed this meta-analysis to evaluate the role of PDS in COVID-19 patients compared to non-pulse steroids (NPDS). Methods: Comprehensive literature search of PubMed, Embase, and Cochrane Library databases from inception through December 01, 2021 was performed for all published studies comparing PDS to NPDS therapy to manage hypoxic patients with COVID-19. Primary outcome was mortality. Secondary outcomes were the need for endotracheal intubation, hospital length of stay (LOS), and adverse events in the form of superimposed infections. Results: A total of nine observational studies involving 2632 patients (1080 patients received PDS and 1552 received NPDS) were included. The mortality rate was similar between PDS and NPDS groups (RR 1.19, 95% CI 0.86-1.65, P=0.28). There were no differences in the need for endotracheal intubation (RR 0.71, 95% CI 0.37-1.137, P=0.31), LOS (MD 1.93 days; 95% CI -1.46, 5.33; P=0.26), or adverse events (RR 0.93, 95% CI 0.56-1.57, P = 0.80) between the two groups. Conclusion: Compared to NPDS, PDS was associated with similar mortality rates, need for endotracheal intubation, LOS, and adverse events. Given the observational nature of the included studies, randomized controlled trials are warranted to validate our findings. https://dx.doi.org/10.46570/utjms.vol11-2023-773 https://dx.doi.org/10.46570/utjms.vol11-2023-773 mailto:Elizabeth.Borchers@rockets.utoledo.edu