Observational studyThe Lancet. Digital health2022
Implementation of corticosteroids in treatment of COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK: prospective, cohort study.
Observational study in The Lancet. Digital health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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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
25 citing papers in PubMed, 28 citations in OpenAlex.
- Stage-, dose- and course-dependent disruption of mice fetal ovarian development following prenatal dexamethasone exposure.Journal of ovarian research · 2026Article
- miR-135a-5p Is a Promising Target to Prevent the Glomerulosclerosis Associated with Podocyte Developmental Toxicity in Offspring Induced by Prenatal Dexamethasone Exposure.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Dexamethasone induces transgenerational inheritance of fetal-derived glomerulosclerosis phenotype in offspring through GR/DNMT3a mediated alterations of the lncRNA-Meg3/Notch signaling pathway.Cell communication and signaling : CCS · 2025Article
- Causal inference can lead us to modifiable mechanisms and informative archetypes in sepsis.Intensive care medicine · 2024Review
- Evaluating the Risk-Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review.Pharmacy (Basel, Switzerland) · 2024Article
- The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided.JAMA · 2024Article
- Multi-organ developmental toxicity and its characteristics in fetal mice induced by dexamethasone at different doses, stages, and courses during pregnancy.Archives of toxicology · 2024Article
- Antimicrobial consumption in an acute NHS Trust during the COVID-19 pandemic: intervention time series analysis.JAC-antimicrobial resistance · 2024Article
- Approaches Towards Better Immunosuppressive Agents.Current topics in medicinal chemistry · 2024Review
- COVID-19 Infection and Clinical Outcomes in Hospitalized Patients With Rheumatoid Arthritis: Insights From the National Inpatient Sample.Journal of community hospital internal medicine perspectives · 2024Article
- Bioinformatics and system biology analysis revealed the crosstalk between COVID-19 and osteoarthritis.Immunity, inflammation and disease · 2023Article
- COVID-19 With Stress Cardiomyopathy Mortality and Outcomes Among Patients Hospitalized in the United States: A Propensity Matched Analysis Using the National Inpatient Sample Database.Current problems in cardiology · 2023Review
- COVID-19 and Acute Ischemic Stroke Mortality and Clinical Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample.Journal of clinical medicine · 2023Article
- Exosomal miR-145 and miR-885 Regulate Thrombosis in COVID-19.The Journal of pharmacology and experimental therapeutics · 2023Article
- Evidence-based prescription of corticosteroids for COVID-19 patients: A comparison between general medicine and other specialty in Japan.Journal of general and family medicine · 2022Article
- Article
- Assessing medication use patterns in patients hospitalised with COVID-19: a retrospective study.BMJ open · 2022Observational
- Multi-Omics Reveals Mechanisms of Partial Modulation of COVID-19 Dysregulation by Glucocorticoid Treatment.International journal of molecular sciences · 2022Article
- Article
- Call for a unified approach to Monkeypox infection in pregnancy: Lessons from the COVID-19 pandemic.Nature communications · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundDexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care.
methodsWe did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260.
findingsBetween June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70-0·89], p=0·0001, for 70-79 years; 0·52 [0·46-0·58], p<0·0001, for >80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75-80% in January, 2021.
interpretationImplementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered.
fundingUK National Institute for Health Research and UK Medical Research Council.
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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.