Tutorial presented by Dr Jon Underwood, Infectious diseases and Acute Medicines Consultant.
There is good evidence that Corticosteroids provide a mortality benefit in COVID-19 (see links to the RECOVERY trial below) for patients on supplementary oxygen and those receiving mechanical ventilation.
The World Health Organisation make a strong recommendation for patients who are severely or critically unwell to receive corticosteroids. For patients who do not require supplemental oxygen, steroids are not recommended.
There are a few clinical considerations to make when using corticosteroids for patients with COVID-19, including hypoglycaemia and increased risk of GI bleeds. Find attached the guidance from the Association for British Clinical Diabetologists (ABCD) have produced useful guidance on the management of hyperglycaemia for patients with COVID-19 who receive dexamethasone (linked below). Recommended for patients to have GI prophylaxis with a PPI in patients on dexamethasone and enhanced thromboprophylaxis/other anticoagulants/anti-platelets that increase the risk of bleeding (e.g. omeprazole 40mg OD for duration of dexamethasone).