No clinical benefit of high dose corticosteroid administration in patients with COVID-19: A preliminary report of a randomized clinical trial

Eur J Pharmacol. 2021 Apr 15;897:173947. doi: 10.1016/j.ejphar.2021.173947. Epub 2021 Feb 16.

Abstract

The aim of this study was to evaluate the clinical effects of dexamethasone administration in patients with mild to moderate acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). The study included 50 patients who were randomly assigned to the dexamethasone group or control group. Dexamethasone was administered at a dose of 20 mg/day from day 1-5 and then at 10 mg/day from day 6-10. The need for invasive mechanical ventilation, death rate, duration of clinical improvement, length of hospital stay, and radiological changes in the computed tomography scan were assessed. The results revealed that 92% and 96% of patients in the dexamethasone and control groups, respectively, required noninvasive ventilation (P = 0.500). Among them, 52% and 44% of patients in the dexamethasone and control groups, respectively, required invasive mechanical ventilation (P = 0.389). At the end of the study, 64% of patients in the dexamethasone group and 60% of patients in the control group died (P = 0.500); the remaining patients were discharged from the hospital during the 28-day follow-up period. The median length of hospital stay was 11 days in the dexamethasone group and 6 days in the control group (P = 0.036) and the median length of hospital stay was 7 days in the dexamethasone group and 3 days in the control group (P < 0.001). No significant differences were observed in the other outcomes. This study showed that corticosteroid administration had no clinical benefit in patients with COVID-19-induced mild to moderate ARDS.

Keywords: COVID-19; Corticosteroids; Dexamethasone; SARS-Cov-2.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • COVID-19 / complications*
  • COVID-19 / drug therapy*
  • COVID-19 / mortality
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Negative Results
  • Respiration, Artificial
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / etiology*
  • Respiratory Distress Syndrome / mortality
  • Tomography, X-Ray Computed
  • Treatment Failure

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone