Higher dose corticosteroids in hospitalised COVID-19 patients requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial

medRxiv - Infectious Diseases Pub Date : 2024-09-06 DOI:10.1101/2024.09.04.24312992

RECOVERY Collaborative Group, Peter W Horby, Jonathan R Emberson, Louise Thwaites, Mark Campbell, Leon Peto, Guilherme Pessoa-Amorim, Natalie Staplin, Raph L Hamers, John Amuasi, Jeremy Nel, Evelyne Kestelyn, Nguyen Thanh Phong, Anil Shrestha, Nasronudin Nasronudin, Rahuldeb Sarkar, Pham Ngoc Thach, Damodar Patel, Uun Samardi, Richard Stewart, Erni Nelwan, Manisha Rawal, J Kenneth Baillie, Maya H Buch, Jeremy N Day, Saul N Faust, Thomas Jaki, Katie Jeffery, Edmund Juszczak, Marian Knight, Wei Shen Lim, Marion Mafham, Alan Montgomery, Andrew Mumford, Kathryn Rowan, Buddha Basnyat, Richard Haynes, Martin J Landray

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Abstract

Background Low-dose corticosteroids (e.g. 6 mg dexamethasone) have been shown to reduce mortality for hypoxic COVID-19 patients. We have previously reported that higher dose corticosteroids cause harm in patients with hypoxia but not receiving ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation or extra-corporeal membrane oxygenation), but the balance of efficacy and safety in patients receiving ventilatory support is uncertain.

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