Systemic corticosteroids decrease mortality in critically ill patients with COVID-19, and the World Health Organization, therefore, recommends dexamethasone 6 mg daily for up to 10 days for patients with severe or critical COVID-19. In addition, higher doses of systemic corticosteroids have been used in patients with COVID-19 and non-COVID-19 acute respiratory distress syndrome [3, 5, 6], and higher doses have been hypothesised to benefit patients with severe or critical COVID-19. However, the balance between benefit and harm remains uncertain.

The COVID STEROID 2 trial compared a higher (12 mg) versus recommended dose (6 mg) of dexamethasone daily, for up to 10 days, in patients with COVID-19 and severe hypoxaemia.

Dr Granholm was interviewed by ICM Associate Editor Dr Shankar-Hari about the methodology and the findings of the study.

Original paper: Dexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxaemia: a pre-planned, secondary Bayesian analysis of the COVID STEROID 2 trial


Anders GRANHOLM. Department of Intensive Care, Rigshospitalet—Copenhagen University Hospital (DK) and Collaboration for Research in Intensive Care (CRIC), Copenhagen (DK).

Manu SHANKAR-HARI. Usher Institute, University of Edinburgh (UK) and Centre for Inflammation Research, University of Edinburgh (UK)and School of Immunology and Microbial Sciences, King’s College London, (UK). ICM Associate Editor.

Comment on this news