The WHO 'Strongly' Recommends Corticosteroid Therapy

A WHO panel announced 2 recommendations regarding the use of steroids to treat severely and critically ill patients on September 2, 2020. A strong recommendation was issued for systemic (i.e. intravenous or oral) corticosteroid therapy (6 mg of dexamethasone orally or intravenously daily or 50 mg of hydrocortisone intravenously every 8 hours) for 7 to 10 days in patients with severe and critical COVID-19 disease.

And, a conditional recommendation, not to use corticosteroid therapy in patients with non-severe COVID-19.

These WHO recommendations mean 'Given the moderate certainty evidence of an important reduction in the risk of death, the panel concluded that all or almost all fully informed patients with severe or critical COVID-19 would choose treatment with systemic corticosteroids. Moreover, the panel believed that other perspectives (i.e. costs, equity, the feasibility of implementation), and patient values and preferences would not alter decisions.

In contrast, the panel concluded that fully informed patients with non-severe COVID-19 would mostly not choose to receive this treatment given that current data indicated they would not likely derive benefit and may derive harm.