Dexamethasone is not recommended for treatment of residents with mild to moderate COVID-19 (patients not on supplemental oxygen for hypoxia related to COVID-19). Dexamethasone is only recommended for severely ill patients with COVID-19 who are on supplemental oxygen for hypoxia related to COVID-19. A meta-analysis study showed no benefit among patients treated with steroids who did not require oxygen or ventilatory support, and a non-statistically significant trend towards higher mortality.

Special circumstance use of dexamethasone in the skilled nursing facility.

In nursing facilities, there may be a role for the use of dexamethasone for a resident with COVID-19 who is hypoxic with advance directives of “Do not transfer to Hospital.” A discussion of risks and benefits of dexamethasone treatment in the nursing home by the Attending Provider is recommended.

  • Dexamethasone 6 mg oral daily for 10 days