Dexamethasone Improves Survival in Severe COVID-19

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Preliminary results from a study showing a survival benefit with dexamethasone in COVID-19 — previously reported by the researchers — have now been published in the New England Journal of Medicine.

In the open-label RECOVERY trial, some 2100 U.K. patients hospitalized with COVID-19 were randomized to usual care plus oral or intravenous dexamethasone (6 mg once daily for up to 10 days), and 4300 were randomized to usual care alone.

Among patients on invasive mechanical support at the time of randomization, the mortality rate within 28 days was significantly lower with dexamethasone than with usual care alone (29% vs. 41%). A benefit was also seen among those on oxygen without invasive ventilation (23% vs. 26%). However, among patients not receiving respiratory support, mortality rates did not differ significantly between treatment groups.

The study authors note that U.S. and U.K. guidelines "have already been updated to recommend the use of glucocorticoids in patients hospitalized with COVID-19." In an accompanying editorial, Drs. H. Clifford Lane and Anthony Fauci of the National Institute of Allergy and Infectious Diseases say the findings "[provide] clarity to an area of therapeutic controversy and probably will result in many lives saved."