Corticosteroids for patients hospitalized for community-acquired pneumonia (CAP) can lower the risk of death within 30 days by 28%, as published in The Lancet Respiratory Medicine. Researchers in the Netherlands analyzed 8 published trials that used risk-and-effect modeling and intent-to-treat to compare adjuvant corticosteroid treatment with a placebo in 3,224 hospitalized CAP patients. Of those studied, 7.6% (246 patients) died within 30 days of diagnosis (6.6% of 1,618 in the corticosteroid group vs 8.7% [140 patients] of 1,606 in the placebo group; odds ratio, 0.72—a 28% reduction). According to the authors, the treatment effect varied significantly among subgroups based on C-reactive protein (CRP) concentrations, “with a substantial mortality reduction observed only in patients with high baseline CRP.”
The overall picture: CAP features a hospitalization rate of about 2% in people 65 years or older and is associated with a 30-day mortality rate of 6% in hospitalized patients, according to a 2022 evidence review in American Family Physician.