Dexamethasone has been shown to improve outcomes in COVID-19 patients requiring oxygen therapy. The RECOVERY trial demonstrated that low-dose dexamethasone reduced 28-day mortality among hospitalized patients receiving either invasive mechanical ventilation or oxygen alone.
Reduction in in-hospital mortality
In patients needing supplemental oxygen, early administration of dexamethasone was associated with a reduction in in-hospital mortality or discharge to hospice based on a national cohort study of 80,699 patients. However, in patients not requiring oxygen, dexamethasone did not show benefit and might be harmful.
No benefits from higher doses
Regarding dosage, higher doses of dexamethasone have not consistently shown additional benefits over the standard 6 mg daily regimen. A randomized clinical trial suggest that higher doses may reduce clinical worsening in hospitalized patients needing oxygen therapy, while others indicate little to no difference in mortality rates compared to standard doses.
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