Trial reportPloS one2022
Low-dose versus high-dose dexamethasone for hospitalized patients with COVID-19 pneumonia: A randomized clinical trial.
Trial report in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04707534 (Effects of Higher Dose and Lower Dose of Dexamethasone for Hospitalized Patients With COVID-19), which is not on this map. Cited by 18 papers, 3 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.
Effects of Higher Dose and Lower Dose of Dexamethasone for Hospitalized Patients With COVID-19
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 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
- 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
- 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
- Trial
- Active surveillance of cytomegalovirus and pulmonary aspergillosis in critically ill patients with COVID-19: risk assessment of high-dose steroids.BMC infectious diseases · 2026Article
- The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.Pneumonia (Nathan Qld.) · 2026Review
- Hyperglycemia and insulin use in patients with COVID-19 and severe hypoxemia allocated to 12 mg vs. 6 mg of dexamethasone: a secondary analysis of the COVID STEROID 2 randomized trial.Annals of intensive care · 2025Article
- Guardians Turned Culprits: NETosis and Its Influence on Pulmonary Fibrosis Development.Molecular biotechnology · 2025Review
- Higher dose corticosteroids in hospitalised COVID-19 patients requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial.EClinicalMedicine · 2025Article
- Dosage and utilization of dexamethasone in the management of COVID-19: A critical review.World journal of virology · 2024Article
- In-hospital survival of critically ill COVID-19 patients treated with glucocorticoids: a multicenter real-world data study.Scientific reports · 2024Article
- Article
- Evaluation of High-doseCurrent drug safety · 2024Observational
- CCR5/CXCR3 antagonist TAK-779 prevents diffuse alveolar damage of the lung in the murine model of the acute respiratory distress syndrome.Frontiers in pharmacology · 2024Article
- A patient-tailored approach for corticosteroid treatment in COVID-19: still not there yet.The European respiratory journal · 2023Article
- Corticosteroids in COVID-19: pros and cons.Frontiers in medicine · 2023Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDexamethasone 6 mg daily for 10 days is the recommended treatment for patients with severe or critical coronavirus disease 2019 (COVID-19). The evidence on the benefit of high-dose dexamethasone is limited. The goal of this study was to assess the effects of 6 mg daily vs. 20 mg daily of dexamethasone in hospitalized patients with COVID-19 pneumonia.
methodsWe conducted a single-center, randomized, clinical trial involving hospitalized patients with COVID-19 pneumonia. Participants were randomized 1:1 to dexamethasone 6 mg daily or dexamethasone 20 mg daily, and were stratified by the WHO-Ordinal Scale for Clinical Improvement (OSCI). The primary outcome was clinical improvement equal to or greater than 2 points by OSCI on day 28. Secondary outcomes were 28-day mortality, intensive care unit-free days, and ventilator-free days on day 28.
resultsOf the 107 patients who enrolled and completed the follow up, 55 patients enrolled in the low-dose group and 52 patients enrolled in the high-dose group. Treatment with dexamethasone 20 mg daily compared with dexamethasone 6 mg daily did not result in better clinical improvement based on OSCI on day 28 (71.2% vs. 78.2%; odds ratio, 1.45 [0.55-3.86]; p = 0.403). For participants who required high-flow oxygen or noninvasive ventilation at randomization, the 6-mg group had better survival than the 20-mg group on day 28 (100% vs. 57.1%; p = 0.025). Although more participants in the 6-mg group received immune modulators (40% vs. 21.2%; p = 0.035), 50% of death cases in the 20-mg group who required high-flow oxygen or noninvasive ventilation at randomization received immune modulators.
conclusionsDexamethasone 20 mg daily did not result in better clinical outcome improvement, and was probably associated with higher 28-day mortality in patients on high-flow oxygen or noninvasive ventilation, compared with dexamethasone 6 mg daily.
trial registrationClinialtrials.gov number, NCT04707534, registered January 13, 2021.
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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.