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In patients with severe community-acquired pneumonia (CAP), recent studies have shown that fewer deaths occur when systemic corticosteroids are used (NEJM JW Gen Med Apr 15 2023 and N Engl J Med 2023; 388:1931); however, defining “severe” for patients with CAP has not been consistent across studies. In an individual patient meta-analysis of 3200 patients in 8 randomized trials, authors assessed various risk-stratification parameters — pneumonia severity index, CURB-65 score, initial intensive care unit (ICU) admission or invasive mechanical ventilation, and C-reactive protein (CRP) level — to determine if any of them could accurately predict improved outcomes with corticosteroids.
Admission CRP level was the only parameter that showed signif…