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