Trial reportJournal of intensive care medicine2022
High- Versus Low-Dose Dexamethasone for the Treatment of COVID-19-Related Acute Respiratory Distress Syndrome: A Multicenter, Randomized Open-Label Clinical Trial.
Trial report in Journal of intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Efficacy and safety of glucocorticoids in the treatment of COVID-19: a systematic review and meta-analysis of RCTs.Clinical and experimental medicine · 2024Pooled it
- Guidance for prevention and management of COVID-19 in children and adolescents: A consensus statement from the Pediatric Infectious Diseases Society Pediatric COVID-19 Therapies Taskforce.Journal of the Pediatric Infectious Diseases Society · 2024Pooled it
- Efficacy and safety of glucocorticoids use in patients with COVID-19: a systematic review and network meta‑analysis.BMC infectious diseases · 2023Pooled it
- Intermediate- to high-dose dexamethasone versus low-dose dexamethasone in patients with COVID-19 requiring respiratory support: a systematic review and meta-analysis of randomized trials.Inflammopharmacology · 2023Pooled it
- Comparison of Preprint Postings of Randomized Clinical Trials on COVID-19 and Corresponding Published Journal Articles: A Systematic Review.JAMA network open · 2023Pooled it
- Systemic corticosteroids for the treatment of COVID-19: Equity-related analyses and update on evidence.The Cochrane database of systematic reviews · 2022Pooled it
- Effects of two different dexamethasone dosing regimens on ventilator-free days and long-term mortality in COVID-19 patients with moderate-to-severe ARDS: the REMED randomized clinical trial.European journal of medical research · 2024Trial
- High-Dose Dexamethasone and Oxygen Support Strategies in Intensive Care Unit Patients With Severe COVID-19 Acute Hypoxemic Respiratory Failure: The COVIDICUS Randomized Clinical Trial.JAMA internal medicine · 2022Trial
- Long-term outcomes of dexamethasone 12 mg versus 6 mg in patients with COVID-19 and severe hypoxaemia.Intensive care medicine · 2022Trial
- Low-dose versus high-dose dexamethasone for hospitalized patients with COVID-19 pneumonia: A randomized clinical trial.PloS one · 2022Trial
- Association between steroid therapy and increased mortality in patients at risk for ARDS.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- Review
- Annexin A1 as a key modulator of lung inflammation during coronavirus infections.Clinical science (London, England : 1979) · 2025Article
- Exploring pharmacological strategies in the management of ARDS: Efficacy, limitations, and future directions.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Review
- Higher dose corticosteroids in hospitalised COVID-19 patients requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial.EClinicalMedicine · 2025Article
- The impact of dexamethasone on short- and long-term mortality in hospitalized COVID-19 patients: a retrospective study.BMC infectious diseases · 2024Article
- Corticosteroids for hospitalized patients with severe/critical COVID-19: a retrospective study in Chongqing, China.Scientific reports · 2024Article
- Glucocorticoid therapy for acute respiratory distress syndrome: Current concepts.Journal of intensive medicine · 2024Review
- Dosage and utilization of dexamethasone in the management of COVID-19: A critical review.World journal of virology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether high-dose dexamethasone increases the number of ventilator-free days (VFD) among patients with acute respiratory distress syndrome (ARDS) caused by COVID-19.
designMulticenter, randomized, open-label, clinical trial.
participantsConsecutive patients with confirmed COVID-19-related ARDS were enrolled from June 17, 2020, to March 27, 2021, in four intensive care units (ICUs) in Argentina.
intervention16 mg of dexamethasone intravenously daily for five days followed by 8 mg of dexamethasone daily for five days or 6 mg of dexamethasone intravenously daily for 10 days. MAIN OUTCOME AND MEASURES: The primary outcome was ventilator-free days during the first 28 days. The secondary outcomes were all-cause mortality at 28 and 90 days, infection rate, muscle weakness, and glycemic control in the first 28 days.
resultsData from 98 patients who received at least one dose of dexamethasone were analyzed. The trial was prematurely terminated due to low enrollment rate. At 28 days after randomization, there was no difference between high- and low-dose dexamethasone groups in VFD (median, 0 [interquartile range [IQR] 0-14] vs. 0 [IQR 0-1] days;
conclusionsAmong patients with ARDS due to COVID-19, the use of higher doses of dexamethasone compared with the recommended low-dose treatment did not show an increase in VFD. However, the higher dose significantly improved the time required to liberate them from the ventilator.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.