Adjunct corticosteroids likely reduce short-term mortality in severe non-COVID-19 pneumonia

Publication date: Dec 02, 2025

Corticosteroids may also reduce secondary shock in severe pneumonia and appear to have little to no association with hospital-acquired infections or secondary pneumonia. Primary outcomes included short-term mortality (within 90 days), long-term mortality (beyond 6 months), and infection-related complications, including hospital-acquired infections, secondary pneumonia, bloodstream infections, catheter-related infections, and secondary shock. Although randomized trials in COVID-19 pneumonia have shown mortality benefits with short courses of low-dose corticosteroids, studies in non-COVID-19 pneumonia have not demonstrated similar effects. Overall, low-dose, short-course corticosteroids likely reduce short-term mortality in both severe pneumonia and ARDS, although effects on long-term mortality remain uncertain due to limited data. In this systematic review and meta-analysis, adjunct corticosteroids likely reduce short-term mortality in patients with severe non-COVID-19 pneumonia and acute respiratory distress syndrome. 2. Evidence for long-term mortality was very uncertain, with only one severe pneumonia study reporting 180-day mortality (RR, 0. 76; 95% CI, 0. 64 to 0. 91) and no ARDS data. This systematic review evaluated the impact of corticosteroid therapy on mortality and infectious complications in severe non-COVID-19 pneumonia or ARDS.

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