Society recommendations on the use of corticosteroids in patients with COVID-19–related respiratory illness (as of 7/19/2020)
| Surviving Sepsis Campaign22 (3/28/2020 |
| • In mechanically ventilated adults with COVID-19 and respiratory failure (without ARDS), we suggest against the routine use of systemic corticosteroids. (Weak recommendation, low-quality of evidence) • In mechanically ventilated adults with COVID-19 and ARDS, we suggest using systemic corticosteroids over not using corticosteroids. (Weak recommendation, low-quality of evidence) |
| American Thoracic Society COVID-19: Interim Guidance23 (4/3/2020) |
| • For hospitalized patients with COVID-19 who have evidence of pneumonia, we make no suggestion either for or against treatment with systemic corticosteroids: 15% for intervention; 18% no suggestion; 67% against intervention. (Evidence not available) |
| Infectious Diseases Society of America24 (6/25/2020) |
| • Among hospitalized patients with severea COVID-19, suggests glucocorticoid rather than no glucocorticoids. (Conditional recommendation, moderate certainty of evidence) • Among hospitalized patients with COVID-19 without hypoxemia requiring supplemental oxygen, suggests against the use of glucocorticoid. (Conditional recommendation, low certainty of evidence) aSevere illness is defined as patients with 94% or less SpO2 on room air, and those who require supplemental oxygen, mechanical ventilation, or ECMO |
| National Institutes of Health25 (6/25/2020) |
| • The COVID-19 Treatment Guidelines Panel recommends using dexamethasone (at a dose of 6 mg per day for up to 10 days) for the treatment of COVID-19 in patients who are mechanically ventilated (Strong recommendation) and in patients who require supplemental oxygen but who are not mechanically ventilated (Moderate recommendation). • The Panel recommends against using dexamethasone for the treatment of COVID-19 in patients who do not require supplemental oxygen. (Strong recommendation) |
| World Health Organization Interim Guidance26 (5/27/2020) |
| • Recommends against the routine use of systemic corticosteroids for treatment of viral pneumonia. (Evidence not available) |
ARDS = acute respiratory syndrome; ECMO = extracorporeal membrane oxygenation; SpO2 = peripheral oxygen saturation