corticosteroid therapy in management of myocarditis associated with covid-19; a systematic review of current evidence

Introduction: myocarditis in patients infected with severe acute respiratory syndrome coronavirus 2 (sars-cov-2) seems to be associated with a higher mortality rate. this study aims to summarize the latest evidence on whether the use of corticosteroids in patients with myocarditis associated with covid-19 is necessary.methods: we performed an extensive search using a combination of search terms in pubmed, europe pmc, proquest, ebscohost, and google scholar up to january 2021. full-text articles that met the predefined inclusion criteria were included in the present study.results: the full-texts of 18 articles have been reviewed. thirteen out of the eighteen (72%) patients who got corticosteroid administration experienced major clinical improvements during follow-up while the other five (28%) were experiencing uneventful events. the mean age of the reported patients was 47.8±13.2 years. there was no gender predominance. most of the reported cases were from usa (39%) followed by spain, china, and uk (11% each), while brazil, colombia, france, belgium, and italy contributed one case each. various corticosteroids were used but the most commonly applied were methylprednisolone (89%), hydrocortisone (5.5%), and prednisolone (5.5%). the most common route of administration among the studies was intravenous administration and the duration of treatment varied between one and fourteen days.conclusion: a review of the currently available literature shows that with the use of corticosteroid agents in treating myocarditis associated with covid-19, favorable outcomes are attainable. well-established randomized clinical trials are needed to evaluate the efficacy and safety of using corticosteroids in this condition.