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.

doi:10.1056/NEJMoa2021436

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.

Authors

Peter Horby

Wei Shen Lim

Jonathan R. Emberson

Marion Mafham

Jennifer L. Bell

Louise Linsell

Natalie Staplin

Christopher Brightling

Andrew Ustianowski

Einas Elmahi

Benjamin Prudon

Christopher Green

Timothy Felton

David Chadwick

Kanchan Rege

Christopher Fegan

Lucy C. Chappell

Saul N. Faust

Thomas Jaki

Katie Jeffery

ALAN MONTGOMERY ALAN.MONTGOMERY@NOTTINGHAM.AC.UK
Director Nottingham Clinical Trials Unit

Kathryn Rowan

Professor ED JUSZCZAK ED.JUSZCZAK@NOTTINGHAM.AC.UK
Professor of Clinical Trials and Statistics in Medicine

J. Kenneth Braille

Richard Haynes

Martin J. Landray

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., …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.