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Debate remains about how to treat critically ill patients with COVID-19. Low-dose corticosteroids have become standard of care for patients with COVID-19 and acute respiratory distress syndrome (ARDS); however, prior to the pandemic, a trial suggested benefit for higher-dose steroids for ARDS (Lancet Respir Med 2020; 8:267). Studies also have shown varying results when comparing different forms of noninvasive respiratory support.
Investigators from France randomized more than 500 patients admitted to an intensive care unit with COVID-19 and hypoxemic respiratory failure to high-dose (16.6 mg/day) or low-dose (6 mg/day) dexamethasone. The initial trial design compared high-dose dexamethasone to placebo, but this protocol was modified (based o…