Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report

Horby, Peter; Lim, Wei Shen; Emberson, Jonathan R.; Mafham, Marion; Bell, Jennifer L.; Linsell, Louise; Staplin, Natalie; Brightling, Christopher; Ustianowski, Andrew; Elmahi, Einas; Prudon, Benjamin; Green, Christopher; Felton, Timothy; Chadwick, David; Rege, Kanchan; Fegan, Christopher; Chappell, Lucy C.; Faust, Saul N.; Jaki, Thomas; Jeffery, Katie; Montgomery, Alan; Rowan, Kathryn; Juszczak, Edmund; Braille, J. Kenneth; Haynes, Richard; Landray, Martin J.

Abstract

Background

Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death.

Methods

In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the preliminary results of this comparison.

Results

A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P

Citation

Horby, P., Lim, W. S., Emberson, J. R., Mafham, M., Bell, J. L., Linsell, L., Staplin, N., Brightling, C., Ustianowski, A., Elmahi, E., Prudon, B., Green, C., Felton, T., Chadwick, D., Rege, . K., Fegan, C., Chappell, L. C., Faust, S. N., Jaki, T., Jeffery, K., …Landray, M. J. (2021). Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report. New England Journal of Medicine, 1-11. https://doi.org/10.1056/NEJMoa2021436

• Journal Article Type: Article
• Acceptance Date: Jul 16, 2020
• Online Publication Date: Jul 17, 2020
• Publication Date: Feb 25, 2021
• Deposit Date: Jul 23, 2020
• Publicly Available Date: Jan 18, 2021
• Journal: New England Journal of Medicine
• Print ISSN: 0028-4793
• Electronic ISSN: 1533-4406
• Publisher: Massachusetts Medical Society
• Peer Reviewed: Peer Reviewed
• Pages: 1-11
• DOI: https://doi.org/10.1056/NEJMoa2021436
• Keywords: General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/4783593
• Publisher URL: https://www.nejm.org/doi/10.1056/NEJMoa2021436
• Additional Information: Copyright © 2020 Massachusetts Medical Society.