Limitations
SECONDARY, COVID-19 PNEUMONITIS, DISEASES
The major limitation of this analysis is the question whether short-term corticosteroids are still causative for the effects found at day 180. The trial was not powered for these secondary endpoints; therefore, the results should be considered hypothesis generating.In addition, despite standardized questions in the endpoints, there is a risk of information bias due to the assessment of data as patient interviews.It must be acknowledged that COVID-19 pneumonitis and CAP are different diseases and thus comparison is limited, in spite of similarities in subsequent hyperinflammation and pulmonary affection.The main strengths of the trial are the large number of patients and the randomized placebo-controlled design, preventing many confounders. Moreover, this is the first randomized controlled trial of corticosteroids in CAP investigating long-term outcomes until 180 days.