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We identified 19 eligible studies (3459 individuals), all observational; 13 studies (1917 individuals) were suitable for inclusion in the meta-analysis of mortality . Of these, 12 studied patients infected with 2009 influenza A H1N1 virus (H1N1pdm09). Risk of bias was greatest in the 'comparability domain' of the Newcastle-Ottawa scale, consistent with potential confounding by indication. Data specific to mortality were of very low quality. Reported doses of corticosteroids used were high and indications for their use were not well reported. On meta-analysis , corticosteroid therapy was associated with increased mortality ( odds ratio ( OR ) , 95% confidence interval ( CI ) to ). Pooled subgroup analysis of adjusted estimates of mortality from four studies found a similar association ( OR , 95% CI to ). Three studies reported greater odds of hospital-acquired infection related to corticosteroid therapy ; all were unadjusted estimates and we graded the data as very low quality.

Intervertebral disk – a structure that separates the vertebrae. It serves to absorb the movements of the vertebrae. Intervertebral disc consists of the so-called pulpal core special jelly mass and envelops the fibrous ring, which consists of fibers. Fibrous ring partially fixed to the adjacent vertebral bodies, and partially – to the adjacent intervertebral ligaments. Some parts of the ring are “free” and there may be some stretching of it. Excess load on the fibrous ring leads to the fact that the nucleus breaks pulpal core break fibrous ring at a greater or lesser extent. This leads to the formation of disk herniation .

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