In an observational study conducted in 84 COVID-19 patients with acute respiratory distress syndrome (ARDS) in China, administration of methylprednisolone was associated with reduced progression to death (hazard ratio 0.38, 95% confidence interval 0.20–0.72, p 0.003), although the unadjusted analysis and the relatively small sample size preclude firm generalization and call for further investigation [47]. Indirect data on the possible efficacy (RCT) or effectiveness (observational comparative studies) of corticosteroid therapy come from studies performed in patients with MERS-CoV, SARS-CoV-1 or other viral infections.