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S&T TWOC project version 1
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A clinical interpretation of the Randomized Evaluation of COVID-19 Therapy (RECOVERY) study was performed to provide a useful tool to understand whether, when, and to whom dexamethasone should be administered during hospitalization for COVID-19 A post hoc analysis of data published in the preliminary report of the Randomized Evaluation of COVID-19 Therapy (RECOVERY) study was performed to calculate the person-based number needed to treat (NNT) and number needed to harm (NNH) of 6 mg dexamethasone once daily for up to 10 days vs usual care with respect to mortality At day 28, the NNT of dexamethasone vs usual care was 36 0 (95%CI 24 9–65 1, p <0 05) in all patients, 8 3 (95%CI 6 0–13 1, p <0 05) in patients receiving invasive mechanical ventilation, and 34 6 (95%CI 22 1–79 0, p <0 05) in patients receiving oxygen only (with or without noninvasive ventilation) dexamethasone increased mortality compared with usual care in patients not requiring oxygen supplementation, leading to a NNH value of 26 7 (95%CI 18 1–50 9, p <0 05) NNT of dexamethasone vs usual care was 17 3 (95%CI 14 9–20 6) in subjects <70 years, 27 0 (95%CI 18 5–49 8) in men, and 16 2 (95%CI 13 2–20 8) in patients in which the onset of symptoms was >7 days dexamethasone is effective in male subjects <70 years that require invasive mechanical ventilation experiencing symptoms from >7 days and those patients receiving oxygen without invasive mechanical ventilation;it should be avoided in patients not requiring respiratory support
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