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. 2021 Dec 5;216(4):203–208. doi: 10.5694/mja2.51353

Dexamethasone*

  • Use dexamethasone 6 mg daily intravenously or orally for up to 10 days (or acceptable alternative regimen) in adults with COVID‐19 who are receiving oxygen (including mechanically ventilated patients).

  • Do not routinely use dexamethasone (or other corticosteroids) to treat COVID‐19 in adults who do not require oxygen.

Remdesivir*

  • Consider using remdesivir for adults admitted to hospital with moderate to severe COVID‐19 who do not require ventilation.

  • Do not start remdesivir in adults admitted to hospital with COVID‐19 who require ventilation.

Special considerations for older people living with frailty and those receiving palliative care

It is unclear whether older people or those requiring palliative care were included in the studies on which these recommendations are based. Until further evidence in these populations is available, the Taskforce does not believe a different recommendation should apply, unless contraindicated. Additional variability may be expected in these populations given the potentially different preferences and values placed on outcomes and goals for care, such as symptom relief. Because the benefit to harm ratio is uncertain, the acceptability may vary in these populations due to individual decision making around goals of care.

*

The primary panel for the recommendations is the Disease‐Modifying Treatment and Chemoprophylaxis Panel. Recommendations are reviewed by the Guidelines Leadership Group and approved by the Steering Committee before being published. In addition, all recommendations are reviewed by the Consumer Panel.