Covid trials

related: Pulmonology, ICU intensive care unit, Infectious Disease
tags: #literature
source:

DEXA ARDS

DEXA ARDS showed improvement in mortality with high dose dexamethasone

Remdesivir

source
for patients hospitalized
not on O2 and at risk of progressing (high risk patients))
On O2
within first 10 days of sx onset and until discharge
benefit: faster time to recovery
side effect: nausea, increased liver enzyme levels, anaphylaxis
discontinue if baseline ALT increases > 10x or if ALT level increases
renal dysfunction: may increase liver/renal toxicity. GFR 30 cut off
may be safe in GFR < 30 with CATCO trial
should be given in pregnant patients

dexamethasone

Recovery trial¹
- 10 days 6mg once daily showed lower mortality rate
- benefit seen in pts on O2 or ventilated. No benefit on RA pts
resulted supported by CoDex trial
Covid STEROID 2 trial found no mortality difference between 6 mg vs 12 mg but maybe higher probability of benefit with 12 mg in high levels of respiratory care patients²
Hydrocortisone and methylprednisolone have been studied but no real evidence to support
dexamethasone and methylprednisolone do not have mineralocorticoid effects to be used for stress dose steroids

Links to this note

ICU intensive care unit
- Covid trials