Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial

Clinical and electrocardiographic correlates of myocardial dysfunction after COVID‐19 in nonhospitalised patients in long‐term follow‐up. Data from the polish long‐covid cardiovascular study

“…Several studies have found a negative impact of long-term high-dose corticosteroid therapy during COVID-19 on the occurrence of, among others, myocardial infarction, bacterial sepsis, cerebrovascular and ophthalmological diseases. [44][45][46][47] Similarly, Remdesivir potentially affects cardiac repolarisation. 48 Several studies have reported cardiovascular side effects of Remdesivir, including bradycardia, hypotension, QTc prolongation, nonspecific T wave changes, and cardiac arrest.…”

“…The authors did not consider the effect of drugs intake chronically or during and after infection, which may affect the occurrence and persistence of disorders in long-COVID. The examined patients were not hospitalized and did not take steroids or Remdesivir; this is particularly important due to the influence of corticosteroids [44][45][46][47] or Remdesivir 48 on heart muscle function. Another limitation is the lack of knowledge about whether patients had myocardial dysfunction before contracting COVID-19, as it had not been previously diagnosed.…”

Higher-dose dexamethasone for patients with COVID-19 and hypoxaemia?

“…In this issue of The Lancet, the RECOVERY Collaborative Group 7 reports the results of a multicentre, multicountry, randomised, open-label platform trial evaluating a higher dose of dexamethasone (20 mg once daily for 5 days followed by 10 mg once daily for 5 days) compared with usual care (6 mg dexamethasone once daily for 10 days) in 1272 patients with COVID-19 receiving no oxygen (n=8) or simple oxygen supplementation (n=1264). 769 (60%) participants were male and 503 (40%) were female, with a mean age of 61·1 (SD 17·5) years; 688 (54%) were Asian, 454 (36%) were White, 14 (1%) were Black, and 116 (9%) were of other or unknown ethnicity.…”

“…The occurrence of non-COVID-19 pneumonia and hyperglycaemia was also higher in the higher-dose group. 7 …”