The following is a summary of “Comparison of Standard and Extended Dexamethasone Duration on Mortality in Patients with Severe COVID-19,” published in the December 2024 issue of Pulmonology by Sephien et al. 

The current guidelines recommend dexamethasone 6 mg/day for up to 10 days in patients with severe COVID-19 needing supplemental oxygen or mechanical ventilation, but its usage often exceeds 10 days in practice.  

Researchers conducted a retrospective study to investigate the benefits and risks of standard vs extended dexamethasone use in patients with severe COVID-19.  

They examined consecutive individuals with severe COVID-19 who received 6 mg/day of dexamethasone between January 2021 and December 2021. The primary outcome was in-hospital mortality, comparing individuals treated with dexamethasone for the standard 10-day duration versus those treated for more than 10 days.  

The results showed 1,294 individuals met the inclusion criteria, with 803 receiving the standard 10-day dexamethasone regimen and 491 receiving the extended regimen. The in-hospital mortality rate was significantly higher (P = 0.003) in the extended duration group (36.5%) compared to the standard duration group (28.5%). However, no significant difference was observed in the incidence of major adverse cardiac events (16.1% for the extended group vs 13.2% for the standard group; P = 0.15).  

Investigators concluded the extended duration of dexamethasone therapy was linked with increased in-hospital mortality in patients with severe COVID-19. 

Source: pubmed.ncbi.nlm.nih.gov/39622519