Corticosteroids Reduce Short-Term Deaths in Severe Pneumonia and ARDS

Adjunct low-dose, short-course corticosteroids probably reduce short-term mortality in adults with severe pneumonia or acute respiratory distress syndrome (ARDS), according to a review of 20 randomized trials involving 3459 participants. Drawing from major medical databases through September 2025, the analysis found that corticosteroids (3 mg/kg of body weight per day or less of prednisone-equivalent for 15 days or less, initiated within 7 days of onset) lowered short-term deaths in both severe pneumonia and ARDS, and may also reduce secondary shock in pneumonia, without meaningfully increasing hospital-acquired infections or secondary pneumonia. Evidence for infection-related complications such as bloodstream or catheter-related infections, as well as long-term mortality, remains uncertain, and classification differences across pneumonia studies limit precision. Overall, the findings suggest that carefully timed, low-dose corticosteroids offer meaningful short-term benefits with little measurable added infection risk. Guidelines for corticosteroids in severe community-acquired pneumonia and ARDS have shifted. Source: https://www.acpjournals.org/