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Title:Dexamethasone in hospitalized patients with Covid-19
Authors:ID Horby, Peter (Author)
ID Lim, Wei Shen (Author)
ID Kačar, Mark (With a unit linked name)
ID Landray, Martin J. (Author)
ID Kačar, Mark (Research coworker)
Files:URL URL - Supplement, visit https://www.nejm.org/doi/10.1056/NEJMoa2022926?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#article_supplementary_material
 
URL URL - Source URL, visit https://www.nejm.org/doi/pdf/10.1056/NEJMoa2021436?articleTools=true
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
Abstract:Background: Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. Methods: In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the final results of this assessment. Results: A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P<0.001). The proportional and absolute between-group differences in mortality varied considerably according to the level of respiratory support that the patients were receiving at the time of randomization. In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.92 to 1.55). Conclusions: In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support. (Funded by the Medical Research Council and National Institute for Health Research and others; RECOVERY ClinicalTrials.gov number, NCT04381936; ISRCTN number, 50189673.).
Keywords:Covid-19 -- drug therapy, dexamethasone
Publication status:Published
Publication version:Version of Record
Place of publishing:ZDA
Publisher: Massachusetts Medical Society
Year of publishing:2021
Number of pages:str. 693-704
Numbering:Vol. 384, iss. 8
PID:20.500.12556/DiRROS-15123 New window
UDC:616.9
ISSN on article:1533-4406
DOI:10.1056/NEJMoa2021436 New window
COBISS.SI-ID:109711875 New window
Copyright:© 2021, Massachusetts Medical Society
Note:Nasl. z nasl. zaslona; Član raziskovalne skupine iz Slovenije: Mark Kačar; Opis vira z dne 30. 5. 2022;
Publication date in DiRROS:30.05.2022
Views:488
Downloads:320
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Record is a part of a journal

Title:The New England journal of medicine
Shortened title:New Engl. j. med.
Publisher:Massachusetts Medical Society, NEJM Group
ISSN:1533-4406
COBISS.SI-ID:520038169 New window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:25.02.2021

Secondary language

Language:Undetermined
Keywords:covid-19 -- terapija z zdravili, deksametazon


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