RT Journal Article
T1 Effect of high versus low dose of dexamethasone on clinical worsening in patients hospitalised with moderate or severe COVID-19 pneumonia: an open-label, randomised clinical trial
A1 Taboada Muñiz, Manuel
A1 Rodríguez Núñez, Nuria
A1 Manuel Varela, Pablo
A1 Rodríguez, María Teresa
A1 Abelleira París, Romina
A1 González Noya, Amara
A1 Casal Mouriño, Ana
A1 Díaz Peromingo, José Antonio
A1 Lama López, Adriana
A1 Domínguez, María Jesús
A1 Rábade Castedo, Carlos
A1 Páez Guillán, Emilio Manuel
A1 Riveiro Blanco, Vanessa
A1 Pernas Pardavila, Hadrián
A1 Beceiro, María del Carmen
A1 Caruezo Rodríguez, Valentín
A1 Naveira Castelo, Alberto
A1 Cariñena Amigo, Agustín
A1 Cabaleiro Ocampo, Teresa
A1 Estany Gestal, Ana
A1 Zarra Ferro, Irene
A1 Pose Reino, Antonio
A1 Valdés Cuadrado, Luis
A1 Álvarez Escudero, Julián
K1 COVID-19
K1 Dexamethasone
K1 Oxygen
K1 Treatment Outcome
AB Background: Low-dose dexamethasone demonstrated clinical improvement in patients with coronavirus disease 2019 (COVID-19) needing oxygen therapy; however, evidence on the efficacy of high-dose dexamethasone is limited. Methods: We performed a randomised, open-label, controlled trial involving hospitalised patients with confirmed COVID-19 pneumonia needing oxygen therapy. Patients were randomly assigned in a 1:1 ratio to receive low-dose dexamethasone (6 mg once daily for 10 days) or high-dose dexamethasone (20 mg once daily for 5 days, followed by 10 mg once daily for an additional 5 days). The primary outcome was clinical worsening within 11 days since randomisation. Secondary outcomes included 28-day mortality, time to recovery and clinical status at day 5, 11, 14 and 28 on an ordinal scale ranging from 1 (discharged) to 7 (death). Results: A total of 200 patients (mean±sd age 64±14 years; 62% male) were enrolled. 32 (31.4%) out of 102 patients enrolled in the low-dose group and 16 (16.3%) out of 98 in the high-dose group showed clinical worsening within 11 days since randomisation (rate ratio 0.427, 95% CI 0.216-0.842; p=0.014). The 28-day mortality was 5.9% in the low-dose group and 6.1% in the high-dose group (p=0.844). There was no significant difference in time to recovery, and in the seven-point ordinal scale at days 5, 11, 14 and 28. Conclusions: Among hospitalised COVID-19 patients needing oxygen therapy, high dose of dexamethasone reduced clinical worsening within 11 days after randomisation, compared with low dose. Trial registration: ClinicalTrials.gov NCT04726098.
PB European Respiratory Society
SN 0903-1936
YR 2022
FD 2022-08
LK https://hdl.handle.net/10347/45133
UL https://hdl.handle.net/10347/45133
LA eng
NO Taboada, M., Rodríguez, N., Varela, P. M., Rodríguez, M. T., Abelleira, R., González, A., Casal, A., Díaz Peromingo, J. A., Lama, A., Domínguez, M. J., Rábade, C., Páez, E. M., Riveiro, V., Pernas, H., Beceiro, M. del C., Caruezo, V., Naveira, A., Cariñena, A., Cabaleiro, T., … Álvarez-Escudero, J. (2022). Effect of high versus low dose of dexamethasone on clinical worsening in patients hospitalised with moderate or severe COVID-19 pneumonia: an open-label, randomised clinical trial. The European Respiratory Journal, 60(2), 2102518. https://doi.org/10.1183/13993003.02518-2021
DS Minerva
RD 28 abr 2026