Hyperglycemia and insulin use in patients with COVID-19 and severe hypoxemia allocated to 12 mg vs. 6 mg of dexamethasone: a secondary analysis of the COVID STEROID 2 randomized trial
Primary result · Glycemic events and insulin useResult — go to the resultAdjusted subdistributional HR 1.76 95% CI 1.22–2.54Authors' conclusion
Higher vs. standard doses of dexamethasone were associated with a higher incidence of severe hyperglycemia in patients with COVID-19 and severe hypoxemia, but the average increase in PG was similar between groups.
Study context
- Population
- Patients with COVID-19 and severe hypoxemia
- Participants
- 321 patients
- Comparison
- Dexamethasone 12 mg vs 6 mg
- Higher dosen = 170
- Standard dosen = 151reference
- Primary endpoint
- Hyperglycemic (two plasma glucose (PG) measurements ≥ 11.1 mmol/L), severe hyperglycemic (PG > 20 mmol/L), hypoglycemic (< 3.8 mmol/L) event or use of insulin (time-to-event, adjusted for age, diabetes status, hospital site, mechanical ventilation)
Methodological detailssubpopulation, time-to-event analysis, linear mixed models
- Subpopulation
- Time-to-event analysis
- Linear mixed models
Primary result
Glycemic events and insulin use
Adjusted subdistributional HR
1.76
95% CI 1.22–2.54
P = 0.003
By group
Higher dose vs Standard dose
adjusted subdistributional HR 1.76 (95% CI 1.22–2.54); P = 0.003
As reported in the abstract
Further findings
| Outcome | Average PG increase (mmol/L) (95% CI) | P value | |
|---|---|---|---|
| Average PG change over time (linear mixed models) | 0.5 (- 0.2 to 1.4) | P = 0.149 | |
| −1012Difference, mmol/L (linear scale) |
Original publication
Hyperglycemia and insulin use in patients with COVID-19 and severe hypoxemia allocated to 12 mg vs. 6 mg of dexamethasone: a secondary analysis of the COVID STEROID 2 randomized trial. Ann Intensive Care. Published 15 July 2025. doi:10.
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