Horby (2020)
Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report
https://doi.org/10.1101/2020.06.22.20137273
https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1.full.pdf
Treatment
Treatment for COVID-19 (Treated with dexamethasone vs. Usual care)
COVID-19 (death)
Risk ratio: 0.830 (0.740-0.920) Adjusted model

United Kingdom

Randomized clinical trial

Primary data collection

6425

Randomized controlled trial of dexamethasone in patients hospitalized with COVID-19. The RECOVERY trial is an investigator-initiated, individually randomized, controlled, open-label, adaptive platform trial to evaluate the effects of potential treatments in patients hospitalized with COVID-19. The trial was conducted at 176 National Health Service (NHS) hospital organizations in the United Kingdom, supported by the National Institute for Health Research Clinical Research Network.

Of the 11,320 patients randomized between 19 March and 8 June, 9355 (83%) were eligible to be randomized to dexamethasone. Of these, 2104 were randomized to dexamethasone and 4321 were randomized to usual care, with the remainder being randomized to one of the other treatment arms. Mean age of study participants in this comparison was 66.1 years and 36% patients were female. A history of diabetes was present in 24% of patients, heart disease in 27%, and chronic lung disease in 21%, with 56% having at least one major comorbidity recorded. In this analysis, 82% of patients had laboratory confirmed SARS-CoV-2 infection, with the result currently awaited for 9%. At randomization, 16% were receiving invasive mechanical ventilation or extracorporeal membrane oxygenation, 60% were receiving oxygen only (with or without non-invasive ventilation), and 24% were receiving neither.

Maximum

28 Day


COVID-19 (death)

1519

28-day mortality. 2104 patients randomly allocated to receive dexamethasone. 454 (21.6%) patients allocated dexamethasone died within 28 day.


Treatment

Treatment for COVID-19

preliminary results for the comparison of dexamethasone 6 mg given once daily for up to ten days vs. usual care alone.

Usual care

1065

4321

Treated with dexamethasone

454

2104


Risk ratio

0.830 (0.740-0.920)

Yes

No

Yes

The estimates of rate ratios and risk ratios (both hereon denoted RR) were adjusted for baseline age.


Primary outcome: 28-day mortality

Average

Yes