Dexamethasone 6 mg IV/PO/NG once daily x 10 days or until discharge from hospital, whichever comes sooner, in adult patients
Indicated if symptoms for 5 or more days for individuals with SpO2 less than or equal to 94% on room air or supplemental oxygen, or mechanical ventilation (including ECMO).
If less than 5 days since symptom onset, consult infectious diseases.
Harm has been suggested when corticosteroids are administered early in the viral replication process, suppressing host antiviral response. If early in the COVID-19 infection process, it may be inappropriate to administer corticosteroids (consult ID for guidance).
In the setting of COVID-19 in critical illness and septic shock, hydrocortisone may be a reasonable alternative to dexamethasone.