• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Infectious Disease

High-dose corticosteroids increase morbidity and mortality among hypoxic COVID-19 patients

byNeel MistryandTeddy Guo
May 17, 2023
in Infectious Disease, Public Health, Pulmonology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Patients in the high-dose dexamethasone group reported significantly greater mortality within 28 days of treatment.

2. Occurrence of non-COVID-19 pneumonia and hyperglycemia was more frequent in the high-dose dexamethasone group compared to usual care.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Low-dose corticosteroids has been shown to have clinical benefit among patients with COVID-19 who are hypoxic but not requiring ventilatory support. However, the optimal dose of corticosteroids in this cohort remains unclear and there is limited evidence on whether higher doses of steroids confer morbidity or mortality benefits. This randomized controlled trial aimed to compare the safety and efficacy of high-dose corticosteroids in patients hospitalized with COVID-19 requiring supplemental oxygen but not invasive mechanical ventilation. The primary outcome was 28-day mortality while key secondary outcomes were time to discharge from hospital and invasive mechanical ventilation. According to study results, patients assigned to the high-dose corticosteroid group reported higher mortality and greater adverse outcomes compared to usual care. This study was strengthened by a randomized design with individuals from multiple centers in multiple countries, thus increasing its generalizability.

Click to read the study in The Lancet

Relevant Reading: Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation

RELATED REPORTS

Worsening kidney function observed following SARS-CoV-2 infection in children

Hospital-onset antimicrobial resistance increased during COVID-19 pandemic

The 2 Minute Medicine Podcast Episode 54

In-depth [randomized-controlled trial]: Between May 25, 2021, and May 13, 2022, 2339 patients were screened for eligibility across 93 sites in 6 countries. Included were patients ≥ 18 years with clinically suspected or laboratory-confirmed COVID-19 and hypoxia (SpO2 < 92% on room air). Altogether, 1272 patients (659 in high-dose steroids and 613 in usual care) were included in the intention-to-treat analysis. The high-dose corticosteroid group received dexamethasone 20 mg daily for five days followed by dexamethasone 10 mg daily while the usual care group received dexamethasone 6 mg daily for 10 days or until hospital discharge. The majority of patients (60%) were male and 19% had diabetes at baseline. The primary outcome of 28-day mortality was significantly greater in the high-dose steroid group compared to usual care (19% vs. 12%, rate ratio [RR] 1.59, 95% confidence interval [CI] 1.20-2.10, p=0.0012). Patients in the high-dose steroid group also reported an increased incidence of non-COVID-19 pneumonia (10% vs. 6%, 95% CI 0.7-6.6) and hyperglycemia (22% vs. 14%; absolute difference = 7.4%, 95% CI 3.2-11.5) compared to the low-dose steroid group. Overall, findings from this study suggest that among COVID-19 patients with hypoxia not requiring invasive mechanical ventilation, high-dose steroids significantly worsened clinical outcomes.

Image: PD

©2023 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: corticosteroidsCOVID-19dexamethasoneendotracheal intubationhigh-dose corticosteroidshyperglycemiamechanical ventilationpneumoniaSARS-CoV-2
Previous Post

Once-a-month fitusiran reduces bleeding rates in patients with hemophilia A and B with inhibitors

Next Post

Wellness Check: Exercise

RelatedReports

Being overweight and obese associated with increased incidence of chronic kidney disease
Chronic Disease

Worsening kidney function observed following SARS-CoV-2 infection in children

May 23, 2025
High risk of complications, but low mortality among children with MRSA bacteremia
Infectious Disease

Hospital-onset antimicrobial resistance increased during COVID-19 pandemic

April 28, 2025
The 2 Minute Medicine Podcast Episode 15
2MM Podcast

The 2 Minute Medicine Podcast Episode 54

March 21, 2025
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Measles Outbreak, Tariffs and Healthcare, Pope’s Pneumonia, and Removing Fluoride from Water:

March 18, 2025
Next Post
Female incontinence associated with physical activity

Wellness Check: Exercise

The 2 Minute Medicine Podcast Episode 15

The 2 Minute Medicine Podcast Episode 15

Patient Basics: Alopecia Areata

Ritlecitinib superior to placebo in the treatment of alopecia areata among teens and adults

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Living in a marginalized neighbourhood is associated with worse outcomes in patients with myocardial infarction
  • SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure
  • Nerandomilast slows decline in FVC in idiopathic pulmonary fibrosis
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.