Methodology: 3.5/5
Usefulness: 3.5/5
Question and Methods: This blinded randomized clinical trial compared the effects of 12 mg daily relative to 6 mg daily of dexamethasone in patients with COVID-19 and severe hypoxemia.
Findings: A daily regimen of 12mg of dexamethasone did not show a statistically significant difference in the number of days alive without life support at 28 days or the secondary outcomes studied.
Limitations: Limitations include the potential lack of power to detect statistically significant differences for the outcomes as well as changes in the standard of care management of COVID-19 during the trial.
Interpretation: This randomized controlled trial did not identify a statistically significant difference. Following the results of this trial, a pre-planned Bayesian analysis demonstrated a high probability of benefit with the intervention. Further studies are needed to better identify the effects of high dose corticosteroids in COVID-19.
By: Dr. Kevin Durr
Journal Club Supervisor: Dr. Jeff Perry
Authors
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Dr. Kevin Durr is an FRCPC Emergency Medicine resident the University of Ottawa
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Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.
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Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
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