key: cord-0993511-nzci22va
authors: Lo, Ching-Lung; Syue, Ling-Shan; Ko, Wen-Chien
title: Oral dexamethasone for COVID-19 patients at the initial recognition of hypoxia: can an early dose herald a better outcome?
date: 2021-10-07
journal: J Microbiol Immunol Infect
DOI: 10.1016/j.jmii.2021.07.016
sha: 2d5947036f13387f266418f9226969dd81f3ad68
doc_id: 993511
cord_uid: nzci22va

nan

Due to the COVID-19 pandemic, many asymptomatic or pre-symptomatic patients with COVID-19 may stay at the group quarantine facilities or home. There was a risk of clinical deterioration into silent hypoxia (SaO2 ≤ 94% at room air), and if untreated even sudden death, especially in patients older than 60 years old. 1 An observational study in German included 213 patients with COVID-19 and PaO 2 /FiO 2 <300 mmHg at admission, and 68 (32%) were defined as silent hypoxia. 2 Such a clinical scenario provokes the urgent need of remote monitoring systems or virtual wards to early intervention to prevent adverse outcomes. Despite of the beneficial potential of steroid in early stage of COVID-19 patients with, there may be adverse effects of steroid therapy, including agitation and hyperglycemia. However, a randomised controlled trial showed a single dose of dexamethasone will not cause higher blood glucose level than a placebo. 6 Therefore, early dexamethasone use is likely to have a survival benefit at the inital recognition of hypoxia for COVID-19 patients as one of the first aids at the ambulance or home before the hospital visit. A prospective and randomized clinical study is warranted to justify the rationale of one dose of dexamethasone for COVID-19 patients out of the hospital.

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