Methodology: 3.5/5
Usefulness: 3.5/5

COVID STEROID 2 Trial Group, Munch MW, et al. JAMA. 2021 Nov 9;326(18):1807-1817. doi: 10.1001/jama.2021.18295.

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