Corticosteroids for COVID-19 – New Evidence of Benefit
Corticosteroids for COVID-19 – New Evidence of Benefit
A conversation with Jonathan A. C. Sterne, MA, MSc, PhD of the University of Bristol, Todd W. Rice, MD, MSc of Vanderbilt University, and Janet V. Diaz, MD of the WHO on the latest research supporting the use of hydrocortisone and dexamethasone for treatment of COVID-19 ARDS. Recorded September 2, 2020.Studies discussed in this interview:
• Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19A Randomized Clinical Trial:
https://jamanetwork.com/journals/jama/fullarticle/2770276
• Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19The CoDEX Randomized Clinical Trial
https://jamanetwork.com/journals/jama/fullarticle/2770277
• Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial
https://jamanetwork.com/journals/jama/fullarticle/2770278
• Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19A Meta-analysis
https://jamanetwork.com/journals/jama/fullarticle/2770279
Related Editorial:
Corticosteroids in COVID-19 ARDSEvidence and Hope During the Pandemic
https://jamanetwork.com/journals/jama/fullarticle/2770275
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Topics discussed in this interview:
0:00 Introduction
3:56 Corticosteroids for COVID-19 study results
7:08 Background on the WHO Corticosteroid Guideline
11:48 WHO Guideline recommendations
13:14 Why do steroids work?
14:39 Hydrocortisone vs. Dexamethasone
17:14 Corticosteroids for mild illness
19:10 WHO recommendations for patients with worsening prognosis
21:12 How do you differentiate patients
25:06 The shock group
26:27 COVID-19 shock
27:50 The RECOVERY Trial
29:10 Timing of therapies / combinations of drugs
31:38 Steroids and Remdesivir combination therapy
36:00 Closing remarks
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