Dexamethasone Dose for COVID-19 in a Large U.S. Hospital Network From April 2020 to May 2023.

View Abstract

PURPOSE

While potential harm from high doses of systemic dexamethasone for clinical management of COVID-19 is an important concern, little is known about real world dexamethasone dosing in patients hospitalized with COVID-19 in the United States.

METHODS

Descriptive study to assess dexamethasone daily dose in adults with COVID-19 in a large US hospital network, overall and by respiratory support requirements, extracted using semi- structured nursing notes.

RESULTS

Of 332 430 hospitalizations with a COVID-19 diagnosis, 201 637 (60.7%) hospitalizations included dexamethasone administration. The mean age of recipients was 63 years, 53.0% were male, and 64.5% White. Median time from admission to dexamethasone administration was 0 day (interquartile range [IQR], 0-1 days) and median duration of use was 5 (IQR, 3-9) days. Almost 80% of hospitalizations received standard daily doses (≤ 6 mg daily), 12.7% moderately high daily doses (> 6- ≤ 10 mg daily), and 8.1% high (> 10- ≤ 20 mg daily) or very high daily dose (> 20 mg daily). Over 20% of COVID-19 hospitalizations requiring no oxygen or simple oxygen received high doses of systemic dexamethasone.

CONCLUSIONS

Given the findings from the UK RECOVERY trial, and the general uncertainty around safety of higher dexamethasone doses in those requiring more intense respiratory support, standard daily dexamethasone doses of 6 mg or less for hospitalized COVID-19 requiring supplemental oxygen are recommended.

Investigators
Abbreviation
Pharmacoepidemiol Drug Saf
Publication Date
2024-10-19
Volume
33
Issue
10
Page Numbers
e70018
Pubmed ID
39419771
Medium
Print
Full Title
Dexamethasone Dose for COVID-19 in a Large U.S. Hospital Network From April 2020 to May 2023.
Authors
Bradley MC, Rai A, Cosgrove A, Perez-Vilar S, Fuller C, Rosen E, Eworuke E, McLean LE, Guy JS, Poland RE, Sands KE, Dal Pan GJ