Download Image
    
Share
  
Post
c19early.org
Dexamethasone for COVID-19
15 studies with >20,000 patients
Serious outcome risk
Dexamethasone
Control
2 studies from 2 independent teams in 2 countries show significant benefit.
COVID-19 Dexamethasone studies · October 2026
Recent:
Sines
Maskin
Wu
Munch.
Covid Analysis Dexamethasone for COVID-19: real-time meta-analysis of 15 studies (Version 18)
Meta-analysis using the most serious outcome reported shows 11% [-4‑28%] higher risk, without reaching statistical significance. While overall meta-analysis shows poor results, dexamethasone shows lower risk for a subgroup of v..
Jun 10
 Sines et al., medRxiv, doi:10.64898/2026.06.08.26355201 A Clinical Predictor of Lung Molecular Endotype Identifies Heterogeneity in Corticosteroid Response in Severe COVID-19: an Emulated Target Trial
8% lower mortality (p=0.56). Target trial emulation of 429 mechanically ventilated patients with severe COVID-19 in the USA, showing that corticosteroids were associated with lower 28-day mortality in patients with a predicted Hyper-Inflammatory endotype (OR 0.62, 95..
Mar 25
 Mostafavi et al., bioRxiv, doi:10.64898/2026.03.21.713333 IL-1β and TNF drive endothelial dysfunction and coagulopathy in acute COVID-19
In vitro and mouse study showing benefit with dexamethasone, adalimumab (anti-TNF), anakinra (IL-1R antagonist), and anti-IL-1β antibodies in preventing SARS-CoV-2-induced endothelial dysfunction and coagulopathy.
Mar 6
 Ruan et al., BMC Infectious Diseases, doi:10.1186/s12879-026-12637-8 A bidimensional early intervention strategy of standard of care in combination with corticosteroids in elderly patients with mild to moderate COVID-19 (BEAT-COV study): a multicentre, open-label, randomized controlled trial
RCT 188 elderly patients with mild to moderate COVID-19 showing no significant reduction in progression to severe or critical COVID-19 with oral corticosteroids (dexamethasone 3 mg, 210 prednisolone 20 mg, or methylprednisolone 16 mg).
Feb 24
 Bălan et al., Antibiotics, doi:10.3390/antibiotics15030236 The Resistance Paradox in COVID-19 Ventilator-Associated Pneumonia: A Retrospective Study on Rapid Molecular Stewardship
Retrospective 52 mechanically ventilated ICU patients showing a "resistance paradox" in COVID-19-associated Ventilator-Associated Pneumonia (VAP), with significantly higher carbapenem resistance and fluoroquinolone resistance, d..
Feb 5
 Gordon et al., Pneumonia, doi:10.1186/s41479-025-00192-w The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza
Review of corticosteroid use in influenza and COVID-19 severe pneumonia. In influenza, the weight of evidence associates corticosteroid therapy with increased mortality, delayed viral clearance, and higher rates of secondary infection. In..
Jan 14
 Ozhan et al., Scientific Reports, doi:10.1038/s41598-025-31048-4 Evaluation of the cardiopulmonary effects of repurposed COVID-19 therapeutics in healthy rats
Animal study analyzing potential cardiopulmonary harm with molnupiravir (MOL), favipiravir (FAVI), hydroxychloroquine (HCQL), and dexamethasone (DEX) in healthy Wistar albino rats. In summary: Data suggests molnupiravir may have the highe..
Oct 27
2025
 Shechtman et al., Journal of the Association of Medical Microbiology and Infectious Disease Canada, doi:10.3138/jammi-2025-0010 Extended-duration dexamethasone for the treatment of hospitalized COVID-19 patients in Canada: A randomized clinical trial
Early-terminated open-label RCT of 11 hospitalized COVID-19 patients in Canada, who still required oxygen after 10 days of dexamethasone, showing no benefit with an extended 20-day course versus stopping at 10 days. The extended dexametha..
Sep 2
2025
 Horby et al., medRxiv, doi:10.1101/2025.08.29.25334732 Long-term follow-up of treatment comparisons in RECOVERY: a randomised, open-label, platform trial for patients hospitalised with COVID-19
6-month followup of RECOVERY patients. Results are reported within the respective trials for each treatment.
May 14
2025
 Bepouka et al., Infection and Drug Resistance, doi:10.2147/IDR.S499371 Clinical Characteristics and Mortality Trends Among COVID-19 Patients During the First Four Waves in Ngaliema Clinic, Democratic Republic of the Congo
104% higher mortality (p=0.55). Retrospective 410 hospitalized COVID-19 patients in the Democratic Republic of Congo showing significantly lower mortality with vitamin C treatment.
Nov 26
2024
 Garneau et al., PLOS ONE, doi:10.1371/journal.pone.0313289 Clinical effects of dexamethasone among patients with sickle cell disease hospitalized with COVID-19: Outcomes from a single academic health system
423% higher ICU admission (p=0.14) and 155% longer hospitalization (p=0.06). Retrospective 30 hospitalized patients with sickle cell disease (SCD) showing increased risk of venous thromboembolism (VTE) with dexamethasone treatment for COVID-19. There were also trends towards increased ICU admission and longer hosp..
Nov 25
2024
 Zhao et al., BMC Infectious Diseases, doi:10.1186/s12879-024-10216-3 The impact of dexamethasone on short- and long-term mortality in hospitalized COVID-19 patients: a retrospective study
34% lower mortality (p=0.01). Retrospective 576 hospitalized COVID-19 patients showing lower mortality with dexamethasone treatment. Results are pending author clarification/correction due to critical internal inconsistencies. The respiratory support subgroup counts i..
Oct 22
2024
 Kim et al., Scientific Reports, doi:10.1038/s41598-024-76871-3 One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea
29% higher mortality (p<0.0001). Retrospective 63,369 hospitalized COVID-19 survivors aged 60 years or older in Korea, showing lower 1-year mortality with macrolides (including azithromycin), higher 1-year mortality with corticosteroids (including dexamethasone and..
Oct 17
2024
 Bhat et al., The Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgae734 Effectiveness of Dexamethasone for COVID-19 in Hospitalized Patients With Diabetes: A Retrospective Cohort Study
35% higher mortality (p=0.2) and 46% worse improvement (p=0.02). Retrospective propensity score matched study of 529 hospitalized diabetic COVID-19 patients showing no significant difference in mortality or clinical improvement with dexamethasone treatment.
Oct 16
2024
 Zhuang et al., Scientific Reports, doi:10.1038/s41598-024-75926-9 Corticosteroids for hospitalized patients with severe/critical COVID-19: a retrospective study in Chongqing, China
5% higher mortality (p=0.86). Retrospective 406 hospitalized severe/critical COVID-19 patients in China showing no significant difference in 28-day mortality with corticosteroid treatment (methylprednisolone, dexamethasone, or both). Corticosteroids were associated wi..
Sep 17
2024
 Zhu et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.23-0710 Circulation of COVID-19-Related Medicines on Japanese Websites during the COVID-19 Pandemic and Their Quality and Authenticity
Investigation of the circulation and quality of COVID-19-related medicines sold online in Japan showing poor-quality ivermectin and dexamethasone. Four dexamethasone samples and two ivermectin samples failed quantitative analysis, and thr..
Aug 24
2024
 Duraníková et al., Journal of Clinical Medicine, doi:10.3390/jcm13175013 Prevalence and Risk Factors of Headache Associated with COVID-19
42% lower long COVID (p=0.08) and 3% improvement (p=0.9). Retrospective 295 hospitalized COVID-19 patients in Slovakia showing 35% prevalence of headache, of which 41% of patients had persistent headache 12-15 months after infection. Authors' analysis of long COVID headache is only for the subgr..
Aug 22
2024
 Leavy et al., ERJ Open Research, doi:10.1183/23120541.00474-2024 1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study
Retrospective 1,888 patients hospitalized with COVID-19 in the UK showing no significant difference in health-related quality of life or other patient reported outcomes, physical and mental health outcomes, and organ function one year aft..
Aug 20
2024
 Yen et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09654-w Predictors for cause-specific and timing of deaths in patients with COVID-19: a cohort study in Taiwan
103% higher mortality (p=0.0002). Retrospective 2,196 COVID-19 patients in Taiwan (49% mild cases, 44% moderate, 7% severe) showing significantly higher mortality with dexamethasone.
Aug 9
2024
 Wang et al., Inflammopharmacology, doi:10.1007/s10787-024-01520-0 Impact of corticosteroid doses on prognosis of severe and critical COVID-19 patients with Omicron variant infection: a propensity score matching study
23% higher mortality (p=0.03). Retrospective 1,167 severe/critical COVID-19 patients in China showing higher 28-day mortality with higher doses of corticosteroids (>50mg/day prednisone equivalent) compared to usual doses (30-50mg/day). The type of corticosteroid used d..
Jul 17
2024
 Franco-Moreno et al., Frontiers in Medicine, doi:10.3389/fmed.2024.1385833 Effect of early administration of dexamethasone in patients with COVID-19 pneumonia without acute hypoxemic respiratory failure and risk of development of acute respiratory distress syndrome: EARLY-DEX COVID-19 trial
134% higher ventilation (p=0.41), 217% higher ICU admission (p=0.46), 17% higher ARDS (p=0.81), and 3% shorter hospitalization (p=0.88). RCT 126 hospitalized COVID-19 pneumonia patients not requiring oxygen at admission, showing no significant difference in outcomes with dexamethasone treatment.
May 31
2023
 Horby et al., The Lancet, doi:10.1016/S0140-6736(23)00510-X Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial
15% higher mortality (p=0.15) and 46% higher ventilation (p=0.27). RCT 1,272 hospitalized COVID-19 patients with hypoxia receiving no oxygen or simple oxygen only, showing significantly increased mortality with higher dose dexamethasone compared to usual care (which included low-dose dexamethasone). 6-mo..
Apr 17
2023
 Mourad et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2023.8516 Dexamethasone for Inpatients With COVID-19 in a National Cohort
10% lower mortality (p=0.0002). PSM retrospective 80,699 hospitalized COVID-19 patients showing reduced mortality or discharge to hospice with dexamethasone in patients requiring supplemental oxygen or mechanical ventilation/ECMO, but no significant difference in patien..
Mar 21
2023
 Madamombe et al., Pan African Medical Journal, doi:10.11604/pamj.2023.44.142.37858 Factors associated with COVID-19 fatality among patients admitted in Mashonaland West Province, Zimbabwe 2020-2022: a secondary data analysis
130% higher mortality (p<0.0001). Retrospective 672 COVID-19 patients in Zimbabwe, showing lower mortality with vitamin C and azithromycin treatment, and higher mortality with dexamethasone treatment. Results are pending author clarification/correction due to internal..
Oct 3
2022
 Wu et al., PLOS ONE, doi:10.1371/journal.pone.0275217 Low-dose versus high-dose dexamethasone for hospitalized patients with COVID-19 pneumonia: A randomized clinical trial
133% higher mortality (p=0.11) and 45% worse improvement (p=0.4). RCT 107 hospitalized COVID-19 pneumonia patients showing no significant benefit and potential harm with high-dose dexamethasone (20 mg daily) compared to low-dose dexamethasone (6 mg daily).
Apr 30
2022
 Kocks et al., ERJ Open Research, doi:10.1183/23120541.00129-2022 A potential harmful effect of dexamethasone in non-severe COVID-19: results from the COPPER-pilot study
600% worse recovery (p=0.07). Pilot RCT of 7 outpatients with non-severe COVID-19 suggesting potential harmful effects of dexamethasone treatment. Time to recovery was significantly longer in the dexamethasone group compared to controls (p=0.03). Authors note that sys..
Jan 13
2022
 Tyson et al., Journal of Independent Medicine, doi:10.71189/JIM/2025/V01N02A06 (date from preprint) Low Rates of Hospitalization and Death in 4376 COVID-19 Patients Treated With Early Ambulatory Medical and Supportive Care: A Case Series and Observational Study
98% lower mortality (p<0.0001) and 99% lower hospitalization (p<0.0001). Retrospective 4,376 patients with mild/moderate COVID-19 in the USA treated with multiple medications including HCQ/ivermectin, zinc, azithromycin, budesonide, and dexamethasone (exact treatments specific to each patient), showing signifi..
Dec 13
2021
 Maskin et al., Journal of Intensive Care Medicine, doi:10.1177/08850666211066799 High- Versus Low-Dose Dexamethasone for the Treatment of COVID-19-Related Acute Respiratory Distress Syndrome: A Multicenter, Randomized Open-Label Clinical Trial
10% lower mortality (p=0.1). RCT 98 mechanically ventilated patients with COVID-19-related ARDS showing no significant difference in ventilator-free days (VFD) at 28 days with high-dose dexamethasone (16mg/day for 5 days then 8mg/day for 5 days) versus low-dose dexam..
Nov 25
2021
 Crothers et al., European Respiratory Journal, doi:10.1183/13993003.02532-2021 Dexamethasone in hospitalised COVID-19 patients not on intensive respiratory support
59% higher mortality (p<0.0001). IPTW retrospective 19,973 hospitalized COVID-19 patients showing increased 90-day mortality with dexamethasone in patients not on oxygen and no mortality benefit in patients on low-flow nasal cannula. Authors found consistent results acro..
Nov 9
2021
 Munch et al., JAMA, doi:10.1001/jama.2021.18295 Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia
13% lower mortality (p=0.2). RCT 1,000 hospitalized patients (982 analyzed) with COVID-19 and severe hypoxemia showing no statistically significant difference with 12 mg/d vs 6 mg/d of intravenous dexamethasone.
Apr 30
2021
 Jamaati et al., European Journal of Pharmacology, doi:10.1016/j.ejphar.2021.173947 No clinical benefit of high dose corticosteroid administration in patients with COVID-19: A preliminary report of a randomized clinical trial
7% higher mortality (p=1) and 18% higher ventilation (p=0.78). RCT 50 hospitalized COVID-19 ARDS patients showing no clinical benefit with high-dose dexamethasone.
Mar 8
2021
 Fateh et al., medRxiv, doi:10.1101/2021.03.05.21251351 A single-center retrospective cohort study of Covid-19 medications: Remdesivir, Favipiravir, Methylprednisolone, Dexamethasone, and Interferon β1a and their combinations
Retrospective 324 hospitalized patients in Iran reporting on the use remdesivir, favipiravir, methylprednisolone, dexamethasone, and Interferon β1a and their combinations. There is no control group in this study.
Feb 25
2021
 Horby et al., New England Journal of Medicine, doi:10.1056/NEJMoa2021436 Dexamethasone in Hospitalized Patients with Covid-19
13% lower mortality (p=0.005), 21% lower ventilation (p=0.03), and 9% higher hospital discharge (p=0.003). RCT 6,425 hospitalized COVID-19 patients showing lower 28-day mortality with dexamethasone treatment. The benefit was most pronounced in patients who had symptoms for more than 7 days at randomization, suggesting dexamethasone is most eff..
Oct 6
2020
 Tomazini et al., JAMA, doi:10.1001/jama.2020.17021 Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19
3% lower mortality (p=0.85) and 34% improvement (p=0.07). RCT 299 patients with moderate or severe COVID-19-related ARDS showing increased ventilator-free days with dexamethasone treatment. There was no significant difference in 28-day mortality (56.3% vs 61.5%), ICU-free days, or mechanical ven..
Mar 31
2020
 Villar et al., The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(19)30417-5 Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial
Non-COVID-19 RCT 277 hospitalized mechanically ventilated ARDS patients showing lower mortality with dexamethasone treatment.
Dec 31
2012
 Areskog et al., Veterinary Parasitology, doi:10.1016/j.vetpar.2012.07.011 Dexamethasone treatment interferes with the pharmacokinetics of ivermectin in young cattle
Analysis of ivermectin and dexamethasone treatment in cattle, showing that dexamethasone interfered with the pharmacokinetics of ivermectin and reduced the efficacy of ivermectin.