Coronavirus Disease (COVID-19)
Steroids

Steroids

Indications

Recommended for critically ill and moderately ill adult patients with suspected or confirmed COVID-19 once newly requiring oxygen therapy

  • Patients requiring ventilatory and/or circulatory support, including high-flow nasal oxygen, non-invasive ventilation, invasive mechanical ventilation, or ECMO
  • These patients are usually managed in an intensive care setting

As per Ontario COVID-19 Drugs and Biologics Clinical Practice Guidelines Working Group (Ontario COVID-19 Science Advisory Table)

  • Patients newly requiring low-flow supplemental oxygen
  • These patients are usually managed in hospital wards

As per Ontario COVID-19 Drugs and Biologics Clinical Practice Guidelines Working Group (Ontario COVID-19 Science Advisory Table)

Adult Steroid Therapy

DexAMETHasone 6mg IV/PO daily x 10 days (or until discharge if sooner)

OR

Pregnancy or Breastfeeding steroid options

  • Under 22 weeks gestation:
    • Methylprednisolone 32mg IV x 1 dose, then
    • Methylprednisolone 32mg IV daily or prednisone 40mg PO daily to complete 10 days (or until discharge if sooner)
  • 22-36 weeks gestation:
    • Dexamethasone 6mg IM BID x 48 hours, then
    • Methylprednisolone 32mg IV daily or prednisone 40mg PO daily to complete 10 days (or until discharge if sooner)
  • Over 36 weeks gestation:
    • Methylprednisolone 32mg IV x 1 dose, then
    • Methylprednisolone 32mg IV daily or prednisone 40mg PO daily to complete 10 days (or until discharge if sooner)
  • Breastfeeding: Methylprednisolone 32mg IV daily or dexamethasone 6mg PO/IV daily to complete 10 days (or until discharge if sooner)

Consultation with obstetrics is recommended