The COVID-19 coronavirus has led to a global pandemic of respiratory diseases with an increase in hospitalization and death risk. To keep COVID-19 manageable for healthcare, early treatment is urgently needed to avoid hospitalization. Dexamethasone can dampen the exaggerated cytokine response to COVID-19 and is a promising agent for preventing disease aggravation, hospitalization and death. However, the evidence on the effectiveness, safety and cost-effectiveness of dexamethasone treatment in primary care is inconclusive.
Drug: Dexamethasone
6 mg dexamethasone prescribed during ten days and as a precaution combined with electronic monitoring of saturation and other signs and symptoms
Inclusion Criteria:
- Age ≥18 years
- A positive test for SARS-CoV-2
- A GP consultation for deteriorating COVID-19 symptoms
Additional inclusion criteria in order to be eligible for randomization to the trial:
- Exercise-induced desaturation, defined as SpO2<92% (<90% for COPD patients) and/or an
absolute drop of ≥4% in SpO2 after a 1-minute sit-to-stand test
OR
- SpO2<92% (<90% for COPD patients) in rest with GP's and patient's shared decision to keep
patient at home despite this in itself being an indication for referral to hospital
Exclusion Criteria:
- Inability to understand and sign the written consent form
- Inability to perform saturation measurements or sit-to-stand test
- Not willing to be admitted to hospital
- On the discretion of the recruiting clinician if he or she deems a patient not
eligible
The following criterion will be used to exclude patients from randomization to the trial:
- Contra-indication for dexamethasone
GPRI
Groningen, Netherlands
Janwillem Kocks, Prof, Principal Investigator
General Practitioners Research Institute