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# Dexamethasone (corticosteroids) - Haygood Health

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### [Dexamethasone (corticosteroids)](/c/dexamethasone)

MechanismESTABLISHEDOutcomeA

Claimed

Corticosteroids reduce death in hospitalized patients who need oxygen.

What holds up

Glucocorticoids suppressing inflammation-mediated lung injury is textbook physiology, and severe COVID-19's hyperinflammatory phase fits decades of ARDS and steroid biology. The benefit is real, subgroup-specific, and replicated. In RECOVERY, ventilated patients died at 29.3% vs 41.4% (rate ratio 0.64), and oxygen-only patients at 23.3% vs 26.2% (rate ratio 0.82), for an overall 22.9% vs 25.7% (rate ratio 0.83). The REACT meta-analysis across 12 countries found a summary odds ratio of 0.66 for 28-day mortality with corticosteroids versus usual care or placebo, with little between-trial inconsistency. This is the anchor claim of the set and it grades high honestly.

What it does not show

RECOVERY randomized 6,425 hospitalized patients with a 28-day mortality endpoint, and the WHO REACT prospective meta-analysis independently pooled 7 RCTs in 1,703 critically ill patients with the same mortality signal. The benefit stops exactly where the claim says it does. Patients on no respiratory support had 17.8% vs 14.0% mortality (rate ratio 1.19, CI 0.92-1.55), which is no benefit and compatible with harm. The trial was open-label, and the evidence does not establish which corticosteroid is best head-to-head or support longer courses than studied.

Evidence for

RECOVERY Collaborative Group, N Engl J Med 2021;384(8):693-704, PMID 32678530, WHO REACT Working Group (Sterne JAC et al.), JAMA 2020;324(13):1330-1341, DOI 10.1001/jama.2020.17023

Sources

VERIFIED RECOVERY Collaborative Group, N Engl J Med 2021;384(8):693-704, PMID 32678530. VERIFIED WHO REACT Working Group (Sterne JAC et al.), JAMA 2020;324(13):1330-1341, DOI 10.1001/jama.2020.17023.

## Grade history (append-only)

Every grade change is kept, never overwritten, so the current grade and every prior one stay visible.

Mechanism gradeJustificationGraded byStateGraded at

ESTABLISHEDGlucocorticoids suppressing inflammation-mediated lung injury is textbook physiology, and severe COVID-19's hyperinflammatory phase fits decades of ARDS and steroid biology. The benefit is real, subgroup-specific, and replicated. In RECOVERY, ventilated patients died at 29.3% vs 41.4% (rate ratio 0.64), and oxygen-only patients at 23.3% vs 26.2% (rate ratio 0.82), for an overall 22.9% vs 25.7% (rate ratio 0.83). The REACT meta-analysis across 12 countries found a summary odds ratio of 0.66 for 28-day mortality with corticosteroids versus usual care or placebo, with little between-trial inconsistency. This is the anchor claim of the set and it grades high honestly.admindisplayed2026-10-08T23:52:30.427Z

Outcome gradeJustificationGraded byStateGraded at

ARECOVERY randomized 6,425 hospitalized patients with a 28-day mortality endpoint, and the WHO REACT prospective meta-analysis independently pooled 7 RCTs in 1,703 critically ill patients with the same mortality signal. The benefit stops exactly where the claim says it does. Patients on no respiratory support had 17.8% vs 14.0% mortality (rate ratio 1.19, CI 0.92-1.55), which is no benefit and compatible with harm. The trial was open-label, and the evidence does not establish which corticosteroid is best head-to-head or support longer courses than studied.admindisplayed2026-10-08T23:52:30.428Z

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