Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report

https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1

Reports from  the preliminary results of RECOVERY trial [The RECOVERY trial is registered with ISRCTN (50189673) and clinicaltrials.gov (NCT04381936)]for the comparison of dexamethasone 6 mg given once daily for up to ten days vs. usual care alone are presented. The primary outcome was 28-day mortality. 2104 patients randomly allocated to receive dexamethasone were compared with 4321 patients concurrently allocated to usual care. Overall, 454 (21.6%) patients allocated dexamethasone and 1065 (24.6%) patients allocated usual care died within 28 days (age-adjusted rate ratio [RR] 0.83; 95% confidence interval [CI] 0.74 to 0.92; P<0.001). Dexamethasone reduced deaths by one-third in patients receiving invasive mechanical ventilation (29.0% vs. 40.7%, RR 0.65 [95% CI 0.51 to 0.82]; p<0.001), by one-fifth in patients receiving oxygen without invasive mechanical ventilation (21.5% vs. 25.0%, RR 0.80 [95% CI 0.70 to 0.92]; p=0.002), but did not reduce mortality in patients not receiving respiratory support at randomization (17.0% vs. 13.2%, RR 1.22 [95% CI 0.93 to 1.61]; p=0.14). In patients hospitalized with COVID-19, dexamethasone reduced 28-day mortality among those receiving invasive mechanical ventilation or oxygen at randomization, but not among patients not receiving respiratory support.

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