Low or High Dose of Dexamethasone in Patients With Respiratory Failure by COVID-19
Status:
Completed
Trial end date:
2021-08-31
Target enrollment:
Participant gender:
Summary
After RECOVERY trial publication, low dose (6 mg dexamethasone for 10 days) was recommended
as the usual care treatment in hospitalized patients with respiratory failure by COVID-19
needing oxygen therapy. RECOVERY trial showed how the use of dexamethasone 6 mg / day for ten
days compared to standard treatment without the use of corticosteroids in hospitalized
patients reduced mortality at 28 days (22.9% with dexamethasone vs 25.7% without
dexamethasone). In the dexamethasone group, the incidence of mortality was lower than
standard treatment in patients with hypoxia and the need for mechanical ventilation (29.3%
with dexamethasone vs 41.4% without dexamethasone), in patients admitted to the hospital ward
with a need for oxygen therapy (23.3% with dexamethasone vs 26.2% without dexamethasone), but
they did not find differences between those admitted patients who did not need oxygen
therapy. There are two other studies (DEXA-COVID-19 and CoDEX) where they observed benefits
of the use of dexamethasone 20 mg / day 5 days, and 10 mg / day 5 days (total 10 days) in
patients admitted for respiratory distress syndrome (ARDS) and COVID-19. At present, it is
unclear what dose of dexamethasone is most beneficial in patients with COVID-19 and
respiratory failure.