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WHO Recommends Corticosteroids for Severe COVID-19 After Positive Study Results

By Kelly Young

The World Health Organization recommends systemic corticosteroids to treat patients with severe and critical COVID-19. The guidance coincides with the publication of three randomized trials and a meta-analysis on corticosteroids in JAMA.

The WHO recommends 6 mg of dexamethasone orally or intravenously daily or 50 mg of hydrocortisone intravenously every 8 hours for 7 to 10 days in the most seriously ill patients.

The organization also suggests that corticosteroids not be used to treat patients with milder COVID-19, as they may increase mortality risk in these patients.

In the WHO-sponsored meta-analysis, researchers examined the results of seven trials of corticosteroids versus usual care or placebo among some 1700 critically ill COVID-19 patients. The 28-day mortality rate, the primary outcome, was significantly lower among corticosteroid users (32% absolute mortality for corticosteroids vs. 40% assumed mortality for controls).

Editorialists conclude: "These studies provide evidence and some hope that an effective, inexpensive, and safe treatment has been identified."

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