WHO Recommends Corticosteroids for Treatment of Critically Ill COVID-19 Patients After New Findings Emerge

The World Health Organization (Geneva, Switzerland) has published guidance for clinicians and health care decision-makers that recommends systemic corticosteroids for the treatment of patients with severe and critical COVID-19.

The guidance was developed in collaboration with the non-profit Magic Evidence Ecosystem Foundation (MAGIC), which provided methodologic support to develop and disseminate living guidance for COVID-19 drug treatments. Corticosteroids have received worldwide attention as a potentially effective treatment for COVID-19. WHO partnered with investigators of seven randomized clinical trials evaluating three steroids, dexamethasone, hydrocortisone and methylprednisolone, in more than 1,700 patients. The WHO then combined the data from these seven trials with data from the RECOVERY trial which had published a preliminary report on the impact of corticosteroids.


Based on analysis of the pooled data, steroids were found to be linked to a one-third reduction in deaths among critically ill COVID-19 patients. Dexamethasone resulted in a 36% decline in deaths in 1,282 patients who received treatment in three separate trials. Hydrocortisone which was tested in 374 patients in three trials led to a fall of 31% in deaths while a small trial of methylprednisolone in 47 patients was found to reduce deaths by 9%.

On the basis of these data, the WHO has recommend systemic corticosteroids rather than no systemic corticosteroids for the treatment of patients with severe and critical COVID-19, but has suggested not to use corticosteroids in the treatment of patients with non-severe COVID-19.

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