Complete results of low dose randomized clinical trials Dexamethasone We have confirmed previous preliminary findings that COVID-19 can save the lives of up to one-third of hospitalized patients with severe respiratory complications.
Oxford University-led RECOVERY (Randomized COVid-19th ERapY Assessment) Trial Involves Dexamethasone Mechanical ventilation Or oxygen only.
However, there was no “clear effect” of dexamethasone in patients who did not receive respiratory support.
In a controlled open-label study, 2104 patients were randomly assigned to receive 6 mg oral or intravenous dexamethasone once daily for up to 10 days, and 4321 patients received normal care. Assigned to.
At randomization, 16% had invasive ventilation or extracorporeal membrane oxygenation, 60% had only oxygen, and 24% had neither.
Test results
Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual-treatment group died within 28 days.
Mortality in patients receiving invasive ventilation was 29.3% in patients receiving dexamethasone, compared to 41.4% in patients receiving usual care.
Mortality in people who received oxygen without an invasive ventilator was 23.3%, compared to 26.2% in those who received regular care.
When preliminary results were announced in June, researchers would use dexamethasone in about 8 ventilated or about 25 patients who needed only oxygen, based on the findings. Said to prevent the death of one person.
The authors did not comment further on the post-publication trial. of New England Medical Journal (NEJM).
Last month, Peter Hovey, a professor of emerging infectious diseases and one of the lead investigators in the Nuffield School of Medicine at Oxford University, said: Dexamethasone should be the standard treatment for these patients because it is sufficient to require oxygen therapy.
“Dexamethasone is cheap, ready to use, and ready to save lives around the world.”
so editorial At NEJM, Dr. H. Clifford Lane and Dr. Anthony Forch of the National Institute of Allergy and Infectious Diseases said the results would “define areas of therapeutic controversy and perhaps save many lives.” It was
They said that during the outbreak, when people were dying, there was the temptation that all therapies “should be given the opportunity”, “A field for moving forward and improving patient outcomes.” ..
Dexamethasone in Covid-19 Hospitalized Patients-Preliminary Report. Recovery collaborative group. DOI: 10.1056 / NEJMoa2021436. Online release on July 17, 2020.
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