Nature Magazine, Vol 582, 25 June 2020, p.469

Steroid is First Drug Shown to Prevent Deaths From COVID-19

Dexamethasone's effect most evident among patients on ventilators - cut about 1/3 of deaths. Those receiving oxygen therapy but not on ventilators also had improved prognosis- their risk of death decreased by 20%. Dexamethasone had no beneficial effects for less severe cases.

Results of RECOVERY trial

RECOVERY is one of the largest randomized, controlled trials for coronavirus treatment. It's dexamethasone division enrolled 2,100 participants who received the drug at low-to-moderate doses (6 milligrams per day, 10 days) and compared their health to 4,300 people receiving standard care for COVID-19.

Northwestern University

DEX usage reduced 28-day mortality for patients requiring mechanical ventilation and, to a lesser degree, patients receiving other oxygen therapy.

- Methods
- Results 
- Discussion


28-day mortality and other clinical outcomes in a randomized controlled trial of Dexamethasone (DEX) among hospitalized COVID-19 patients in the UK RECOVERY project

- About the RECOVERY trial
- Study design
- Sample size and ending enrollment
- Statistical analysis


Methods : 28-day mortality and other clinical outcomes in a randomized controlled trial of Dexamethasone (DEX) among hospitalized COVID-19 patients in the UK RECOVERY project

- Patient information and treatment: 2104 patients received treatment, compared with 4321 patients in control group getting (see eligibility and randomization child node for detail)

- “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).” 

- Level of respiratory support significantly associated with mortality rates, with largest reduction among those with mechanical ventilation, moderate reduction in those with oxygen only, and no significant reduction for those without oxygen (see 28-day mortality results node for more detail)

- Use of DEX associated with shorter hospitalization duration (see duration of hospitalization child node)

- Among those not using mechanical ventilation at baseline, fewer patients reached the composite outcome of ventilation or death among those receiving DEX (RR 0.91, 95% CI (0.82, 1.00), p=0.049) with stronger effects in those using oxygen (test for trend p=0.008)

- Risk of new mechanical ventilation was lower in those receiving DEX compared to control (RR 0.76, 95% CI (0.61, 0.96), p=0.021)

- Results summarized in Table 2 node

Results : 28-day mortality and other clinical outcomes in a randomized controlled trial of Dexamethasone (DEX) among hospitalized COVID-19 patients in the UK RECOVERY project

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