Dexamethasone doses in patients with COVID-19 and hypoxia: A systematic review and meta-analysis
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F24%3A00078466" target="_blank" >RIV/65269705:_____/24:00078466 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/24:00135338
Result on the web
<a href="https://onlinelibrary.wiley.com/doi/10.1111/aas.14346" target="_blank" >https://onlinelibrary.wiley.com/doi/10.1111/aas.14346</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1111/aas.14346" target="_blank" >10.1111/aas.14346</a>
Alternative languages
Result language
angličtina
Original language name
Dexamethasone doses in patients with COVID-19 and hypoxia: A systematic review and meta-analysis
Original language description
Background: The optimal dose of dexamethasone for severe/critical COVID-19 is uncertain. We compared higher versus standard doses of dexamethasone in adults with COVID-19 and hypoxia.Methods: We searched PubMed and trial registers until 23 June 2023 for randomised clinical trials comparing higher (>6 mg) versus standard doses (6 mg) of dexamethasone in adults with COVID-19 and hypoxia. The primary outcome was mortality at 1 month. Secondary outcomes were mortality closest to 90 days; days alive without life support; and the occurrence of serious adverse events/reactions (SAEs/SARs) closest to 1 month. We assessed the risk of bias using the Cochrane RoB2 tool, risk of random errors using trial sequential analysis, and certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: We included eight trials (2478 participants), of which four (1293 participants) had low risk of bias. Higher doses of dexamethasone probably resulted in little to no difference in mortality at 1 month (relative risk [RR] 0.97, 95% CI: 0.79-1.19), mortality closest to Day 90 (RR 1.01, 95% CI: 0.86-1.20), and SAEs/SARs (RR 1.00, 95% CI: 0.97-1.02). Higher doses of dexamethasone probably increased the number of days alive without invasive mechanical ventilation and circulatory support but had no effect on days alive without renal replacement therapy.Conclusions: Based on low to moderate certainty evidence, higher versus standard doses of dexamethasone probably result in little to no difference in mortality, SAEs/SARs, and days alive without renal replacement therapy, but probably increase the number of days alive without invasive mechanical ventilation and circulatory support.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30223 - Anaesthesiology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2024
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Acta Anaesthesiologica Scandinavica
ISSN
0001-5172
e-ISSN
1399-6576
Volume of the periodical
68
Issue of the periodical within the volume
2
Country of publishing house
DK - DENMARK
Number of pages
21
Pages from-to
146-166
UT code for WoS article
001090806200001
EID of the result in the Scopus database
2-s2.0-85174852914