Dexamethasone

Adults

  • 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.

Pediatrics

  • There are currently no data on the use of dexamethasone in children with severe disease who require supplemental oxygen or mechanical ventilation, hence clinical judgement should be applied if considering its use in this population.

  • May be considered if other indications are present (e.g., asthma exacerbation)

  • Pediatric Asthma and COVID 19

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