"Dexamethasone in Hospitalized Patients with Covid-19". The New England Journal of Medicine.
Links to original sources: Wiki Journal Post Full Journal Article
Does the addition of dexamethasone to usual care improve 28-day mortality in patients hospitalized with Covid-19?
In hospitalized patients with Covid-19, dexamethasone resulted in lower 28-day mortality among those who were receiving invasive mechanical ventilation or oxygen alone but not among patients without respiratory support.
Severe Covid-19 can lead to respiratory failure and death, potentially related to the host's immune response. The RECOVERY trial evaluated the mortality benefit of dexamethasone, a glucocorticoid, in hospitalized Covid-19 patients requiring respiratory support. The findings demonstrate that dexamethasone reduces 28-day mortality in patients under invasive mechanical ventilation or oxygen therapy but is not beneficial for patients not receiving respiratory support and could potentially be harmful.
Updated guidelines recommend the use of glucocorticoids in patients hospitalized with Covid-19 requiring oxygen with or without ventilatory support.
Multicenter, controlled, open-label trial
6,425 patients hospitalized with Covid-19; 2,104 in the dexamethasone group and 4,321 in the usual care group.
Patients were randomly assigned to receive usual care plus 6 mg of dexamethasone once daily for up to 10 days or usual care alone.
The primary outcome was 28-day mortality. Secondary outcomes included hospital discharge within 28 days and progression to invasive mechanical ventilation or death among patients not on invasive mechanical ventilation at randomization.
- Open-label design without placebo control - Dexamethasone not beneficial for patients without respiratory support
Funded by the Medical Research Council, National Institute for Health Research, and others.
Original publication in The New England Journal of Medicine