RECOVERY (dexamethasone)
Trial question
What is the effect of dexamethasone in patients hospitalized with severe COVID-19?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 6425
6425 patients (2338 female, 4087 male).
Inclusion criteria: hospitalized patients with severe COVID-19.
Key exclusion criteria: unavailability of dexamethasone, clinical judgement of patients' unsuitability for randomization.
Interventions
N=2104 dexamethasone therapy (oral or IV dexamethasone for up to 10 days).
N=4321 no dexamethasone (standard of care).
Primary outcome
Death at 28 days
22.9%
25.7%
25.7 %
19.3 %
12.8 %
6.4 %
0.0 %
Dexamethasone
therapy
No
dexamethasone
Significant
decrease ▼
NNT = 35
Significant decrease in death at 28 days (22.9% vs. 25.7%; RR 0.83, 95% CI 0.75 to 0.93).
Secondary outcomes
Significant increase in discharge from hospital within 28 days (12 vs. 13; RR 1.1, 95% CI 1.03 to 1.17).
Significant decrease in invasive mechanical ventilation (5.7% vs. 7.8%; RR 0.77, 95% CI 0.62 to 0.95).
Conclusion
In hospitalized patients with severe COVID-19, dexamethasone therapy was superior to no dexamethasone with respect to death at 28 days.
Reference
RECOVERY Collaborative Group, Peter Horby, Wei Shen Lim et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021 Feb 25;384(8):693-704.
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