NO features of severe or critical illness (see below).
- Symptomatic (any acute COVID-19 related symptoms)
- AND respiratory rate <24/min
- WITHOUT pneumonia or hypoxia
In patients with persistent fever and high inflammatory markers(e.g., CRP > 10 times ULN) in the second week of the illness we accept there is some equipoise and that some doctors may wish to prescribe this when these markers are present.
NO features of severe or critical illness (see below).
- • Pneumonia (clinical or radiological)
- AND respiratory rate ≤30/min
- AND SpO2 ≥94% on room air
We recommend dexamethasone base 6mg once daily (this is 8mg sodium phosphate salt), oral or IV depending on available route of administration, until discharge or sustained normalization of oxygen saturation, up to a maximum of 10 days.
Drug: This is the drug used in most trials. However, if dexamethasone is not available methyl prednisolone 32mg/day, prednisolone 40mg or hydrocortisone 150mg /day can be used at an equivalent dose.
Moderate illness with hypoxia
NO features of severe or critical illness (see below).
- Hypoxia (SpO2 <94% on room air)
- AND respiratory rate ≤30/min
- AND SpO2 ≥90% on room air
Severe illness
Pneumonia with ANY ONE of the following:
- Respiratory rate >30/min
- Severe respiratory distress
- SpO2 <90% on room air
- NO invasive or non-invasive respiratory support needed
Critical illness:
- Requirement for high-level respiratory support: noninvasive ventilation, high-flow oxygen (≥20 litres per minute) or invasive mechanical ventilation
- OR acute respiratory distress syndrome (PaO2/FiO2 ratio of <300)
- OR sepsis
- OR shock