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Article data
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

Results
Treatment
Treatment for COVID-19 (Treated with dexamethasone vs. Usual care)
COVID-19 (severe/fatal)
Risk ratio: 0.910 (0.820-1.000) Adjusted model

Study characteristics

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


Results

COVID-19 (severe/fatal)

1364

Receipt of invasive mechanical ventilation (including extra-corporeal membrane oxygenation) or death (and its subcomponents). Analyses exclude those on invasive mechanical ventilation at randomization.

Treatment

Treatment for COVID-19

Estimates of the RR and its 95% confidence interval are adjusted for age in three categories (<70 years, 70-79 years, and 80 years or older).

Usual care

939

3638

Treated with dexamethasone

425

1780

Risk ratio

0.910 (0.820-1.000)

Yes

No

Yes

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


Other information

Subsidiary clinical outcomes included cause-specific mortality, receipt of renal hemodialysis or hemofiltration, major cardiac arrhythmia (recorded in a subset), and receipt and duration of ventilation.

Average

Yes

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