The Recovery Trial: Effect of Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report

The findings of this well done randomized controlled trial indicate that in patients with COVID-19 pneumonia, that dexamethasone improves 28d mortality compared to placebo in patients requiring invasive mechanical ventilation (IMV) (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).  There was no benefit to patients not requiring oxygenation support and even a signal for harm.  It is important to remember this is a preprint, preliminary report, which is better than a press release. At this time, in patients requiring any oxygen therapy, HFNC, NIV, IMV, or ECMO I would recommend dexamethasone until further evidence disproves this benefit.

2020 International Society of Hypertension Global Hypertension Practice Guidelines

In accordance with most major guidelines it is recommended that hypertension be diagnosed when a person’s systolic blood pressure (SBP) in the office or clinic is ≥140 mm Hg and/or their diastolic blood pressure (DBP) is ≥90 mm Hg following repeated examination.

COVID-19 Rx: Treatment Simulations

You are a health care provider in a developed country. Several patients await your care. These patients are suspected of having COVID-19 and have been triaged by severity of illness. We recommend starting with the mildly ill patient, but you are free to see them in any order.