Summary of evidence and outcomes reported by guidelines discussing dexamethasone

GuidelinesRCTsOutcomes considered
DEXA-COVID19 (NCT04325061) [46]RECOVERY (NCT04381936) [3]CoDEX (NCT04327401) [47]Jamaati 2021 (IRCT20151227025726N17) [59]Ranjbar 2021 (IRCT20200204046369N1) [60]CostMortalityClinical recoveryDischargeSafetyTime to ICU admissionProgression to IMVOther
Guidelines recommending for the use of dexamethasone in at least one population described
MoH Brazil
COVID-19 Advisory Ontario
Government of Mexico

“✓”: guideline explicitly mentions evidence or outcome. Empty cell: guideline does not explicitly mention evidence or outcome. Organisations: AWMF: Association of the Scientific Medical Societies in Germany; CIDS: Clinical Infectious Disease Society; ERS: European Respiratory Society; IDSA: Infectious Disease Society of America; J-SSCG: Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock; MoH: Ministry of Health; NICE: National Institute for Health and Care Excellence; NIH: National Institutes of Health; SIP: Italian Society of Pulmonology; SITA: Italian Society of Anti-Infective Therapy; SSC: Surviving Sepsis Campaign; WHO: World Health Organization. Abbreviations: ARDS: acute respiratory distress syndrome; ICU: intensive care unit; IMV: invasive mechanical ventilation; NCT: National Clinical Trial; NR: not reported; RCT: randomised controlled trial. Other outcomes considered: a: additional end-points not included in the evidence table which were searched for but were either not studied or data were not found in an extractable format were: clinical resolution or cure (also includes the reverse, i.e. patients not cured); time to clinical improvement or resolution on an ordinal scale; requirement for oxygen; hospital admission; ordinal scale or clinical status at day 28; ICU length of stay; need for noninvasive ventilation; deterioration in those not requiring ventilation at start of treatment; severity of symptoms; improvement in oxygen saturations or arterial blood gases; relapse; viral clearance (negative SARS-CoV-2 test) and duration of fever. b: examined evidence from non-COVID-19 ARDS patients as well. c: ventilator-free days at 28 days; quality of life, including fatigue and neurological status long term; hospital-acquired infections during treatment per 28 days. d: outcomes assessed by end of treatment: gastrointestinal bleeding, bacterial co-infections, hyperglycaemia, neuromuscular weakness and neuropsychiatric effects. e: need for insulin; positive blood cultures at Day 7; sepsis by Day 28; score on 6-point WHO ordinal scale at Day 15; mean Sequential Organ Failure Assessment (SOFA) score; need for rescue strategies; need for oxygenation; organ-support free-days at Day 21; duration of fever; virus clearance time; proportion prescribed antibiotics and antifungal therapy. Sources: AWMF, October 2021 [24]; CIDS, July 2021 [27]; COVID-19 Advisory Ontario, August 2021 [33]; ERS, April 2021 [10]; Government of Mexico, August 2021 [35]; IDSA, October 2021 [36]; J-SSCG, September 2021 [37]; MoH Brazil, May 2021 [38]; NICE, January 2022 [8]; NIH, December 2021 [39]; SITA/SIP, May 2021 [40]; SSC, March 2021 [41]; WHO, January 2022 [9].