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Revista Argentina de Salud Pública
Print version ISSN 1852-8724On-line version ISSN 1853-810X
Abstract
TORTOSA, Fernando et al. Dexametasone treatment in case of COVID-19 infection: Rapid Health Technology Assessment Report. Rev. argent. salud pública [online]. 2020, vol.12, suppl.1, pp.15-15. Epub Dec 10, 2020. ISSN 1852-8724.
INTRODUCTION
the recent publication of the preliminary results of a multicenter randomized trial reporting the effectiveness of dexamethasone treatment in patients with severe SARS-CoV-2 infection; raises the need to conduct a literature review, identify and critically assess the evidence on the effectiveness and safety of this intervention.
METHODS
a broad, non-systematic search was carried out. The GRADE methodology was used to assess the certainty of the included evidence. A multidisciplinary team was formed to carry out a Health Technology Assessment report.
RESULTS
the use of glucocorticoids (dexamethasone 6 mg/day for 10 days) in patients with COVID-19 pneumonia will reduce global mortality at 28 days, (RR 0.83,95% CI 0.75 to 0.93), with a number necessary to treat (NNT) of 33, (High confidence). In patients with severe pneumonia requiring mechanical ventilation (MV), a decrease in mortality was reported (RR, 0.64; 95% CI, 0.51 to 0.81, NNT 8.5) (Moderate confidence). In patients with severe pneumonia with oxygen requirements without MV, it reports a reduction in mortality (RR, 0.82; 95% CI, 0.72 to 0.94), (Moderate confidence). The adverse effects of corticosteroids in critically ill patients have not been described with these doses used.
DISCUSSION
the administration of dexamethasone 6 mg/day (low doses) for 10 days is recommended in patients with SARS-CoV-2 associated severe pneumonia and oxygen or mechanical ventilation requirements.
Keywords : Biomedical Technology Assessment; COVID-19; Dexamethasone; Argentina.