Intended for healthcare professionals

Practice Rapid Recommendations

A living WHO guideline on drugs for covid-19

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379 (Published 04 September 2020) Cite this as: BMJ 2020;370:m3379

Visual summary of recommendation

Population Disease severity Non-severe Severe Critical SpO 2 <90% on room air Respiratory rate >30 in adults Raised respiratory rate in children Signs of severe respiratory distress Requires life sustaining treatment Acute respiratory distress syndrome Sepsis Septic shock Absence of signs of severe or critical disease This recommendation applies only to people with these characteristics: Patients with confirmed covid-19 Recommendation 1 Recommendation 2 ≥60 in children <2 months≥50 in children 2-11 months≥40 in children 1-5 years
Interventions compared Nocorticosteroids Usualsupportive care Corticosteroids Suggested regimen Acceptable alternative regimens Dexamethasone 6 mg Oral or intravenous Hydrocortisone 50 mg Intravenous Every 8 hours for 7-10 days Daily for7-10 days Every 6 hours for 7-10 days Methylprednisolone 10 mg Intravenous Daily for7-10 days Prednisone 40 mg Oral
Recommendation 1 We recommend corticosteroids Usual supportive care Corticosteroids or Patients with severe and critical covid-19 Strong All or nearly all informed people would likely want usual supportive care without corticosteroids. Benefits would outweigh harms for almost everyone Weak Most people would likely want usual supportive care without corticosteroids. Benefits would outweigh harms for the majority, but not for everyone Weak Most people would likely want corticosteroids. Benefits would outweigh harms for the majority, but not for everyone Strong All or nearly all informed people would likely want corticosteroids. Benefits would outweigh harms for almost everyone
Recommendation 2 We suggest no corticosteroids Usual supportive care Corticosteroids or Patients with non-severe covid-19 Strong All or nearly all informed people would likely want usual supportive care without corticosteroids. Benefits would outweigh harms for almost everyone Weak Most people would likely want usual supportive care without corticosteroids. Benefits would outweigh harms for the majority, but not for everyone Weak Most people would likely want corticosteroids. Benefits would outweigh harms for the majority, but not for everyone Strong All or nearly all informed people would likely want corticosteroids. Benefits would outweigh harms for almost everyone

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