Systemic corticosteroids decrease mortality in critically ill patients with COVID-19, and the World Health Organization, therefore, recommends dexamethasone 6 mg daily for up to 10 days for patients with severe or critical COVID-19. In addition, higher doses of systemic corticosteroids have been used in patients with COVID-19 and non-COVID-19 acute respiratory distress syndrome [3, 5, 6], and higher doses have been hypothesised to benefit patients with severe or critical COVID-19. However, the balance between benefit and harm remains uncertain.

The COVID STEROID 2 trial compared a higher (12 mg) versus recommended dose (6 mg) of dexamethasone daily, for up to 10 days, in patients with COVID-19 and severe hypoxaemia.

Dr Granholm was interviewed by ICM Associate Editor Dr Shankar-Hari about the methodology and the findings of the study.

Original paper: Dexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxaemia: a pre-planned, secondary Bayesian analysis of the COVID STEROID 2 trial

Speakers

Anders GRANHOLM. Department of Intensive Care, Rigshospitalet—Copenhagen University Hospital (DK) and Collaboration for Research in Intensive Care (CRIC), Copenhagen (DK).

Manu SHANKAR-HARI. Usher Institute, University of Edinburgh (UK) and Centre for Inflammation Research, University of Edinburgh (UK)and School of Immunology and Microbial Sciences, King's College London, (UK). ICM Associate Editor.