Comparison of Standard and Extended Dexamethasone Duration on Mortality in Patients with Severe COVID-19

Division

West Florida

Hospital

Citrus Memorial Hospital

Document Type

Manuscript

Publication Date

12-1-2024

Keywords

Humans, Dexamethasone, Female, Male, Retrospective Studies, Hospital Mortality, COVID-19 Drug Treatment, COVID-19, Aged, Middle Aged, SARS-CoV-2, Respiration, Artificial, Drug Administration Schedule, Glucocorticoids

Disciplines

Cardiology | Internal Medicine | Medicine and Health Sciences | Pulmonology | Respiratory Tract Diseases | Virus Diseases

Abstract

OBJECTIVES: Current guidelines recommend dexamethasone 6 mg/day for up to 10 days in patients with severe coronavirus disease 2019 (COVID-19) requiring supplemental oxygenation or mechanical ventilation. The practice has significant variation, however, and dexamethasone has been used for >10 days for many patients with severe COVID-19. The aim of this study was to assess the benefits and risks associated with standard versus extended use of dexamethasone in patients with severe COVID-19.

METHODS: A multicenter retrospective cohort study was conducted from January 2021 to December 2021. All of the consecutive patients with severe COVID-19 receiving 6 mg/day dexamethasone were eligible for inclusion. The primary outcome was the incidence of in-hospital mortality for patients treated with dexamethasone 6 mg/day for the standard duration of 10 days versus an extended duration of >10 days.

RESULTS: A total of 1294 patients met the inclusion criteria: 803 received the standard duration of dexamethasone and 491 received the extended duration. The incidence of in-hospital mortality was significantly higher (

CONCLUSIONS: The results show that extended duration of dexamethasone compared with standard duration is associated with a significant increase in in-hospital mortality in patients with severe COVID-19. These findings need to be confirmed in well-designed and performed randomized controlled trials.

Publisher or Conference

Southern Medical Journal

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