Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis

Sao Paulo Med J. 2021 Oct 11;139(6):657-661. doi: 10.1590/1516-3180.2021.0120.R1.30062021. eCollection 2021.


Background: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Objective: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2.

Design and setting: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university.

Methods: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection.

Results: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33).

Conclusions: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. -Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease.

Prospero platform: CRD42021229825.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 Drug Treatment*
  • Communicable Disease Control
  • Dexamethasone / therapeutic use
  • Humans
  • SARS-CoV-2*


  • Dexamethasone