Table 3.

Summary of International Recommendations of Corticosteroid Use in COVID-19

Organization	Date	COVID-19 Population	Recommended Dose	Level of Evidence	Corticosteroid Use Recommendation
Chinese National Health Committee (7th version)	3/4/2020	Progressive deterioration of oxygenation indicators, rapid radiographic progression, and excessive activation of inflammatory response	MP, 1-2 mg/kg/d for 3-5 d	Expert consensus	Favors corticosteroids
The Surviving Sepsis Campaign: Society of Critical Care Medicine/European Respiratory Society	3/28/2020	Patients on mechanical ventilation and ARDS	Hydrocortisone 200 mg/d	Weak recommendation, low-quality evidence	Favors corticosteroids
Infectious Disease Society of America	9/25/2020	Critically ill patients with severe disease, ie, SpO2 ≤ 94% on room air, those who require supplemental oxygen, mechanical ventilation, or ECMO	Dexamethasone 6 mg for 10 d (or until discharge if earlier) or equivalent corticosteroids dose	Strong (critically ill)/conditional (severe disease) recommendation, moderate certainty of evidence	Favors corticosteroids
		Patients without hypoxemia, not requiring supplemental oxygen	. . .	Conditional recommendation, low certainty of evidence	Against corticosteroids
National Institutes of Health	8/27/2020	Patient on mechanical ventilation or requiring oxygen supplementation	Dexamethasone 6 mg/d (or alternative corticosteroids) for up to 10 d or until hospital discharge	AIa (mechanically ventilated patients), BIb (requiring oxygen)	Favors corticosteroids
		Patients not requiring oxygen supplementation	. . .	AIa	Against corticosteroids
World Health Organizationc	9/2/2020	Patients with severe disease and critically ill	Dexamethasone 6 mg/d or hydrocortisone 50 mg every 8 h for 7-10 d	Strong recommendation, moderate certainty evidence	Favors corticosteroids
American Thoracic Society	4/3/2020	No suggestion	. . .	Expert consensus	Against corticosteroids

ECMO = extracorporeal membrane oxygenation; MP = methylprednisolone; SpO₂ = oxygen saturation.

^aGrade A, level 1: strong recommendation, high-quality evidence.

^bGrade B, level 1: strong recommendation, moderate-quality evidence.

^cWorld Health Organization is in the process of updating treatment guidelines to include dexamethasone or other corticosteroids.