Published online Mar 25, 2025. doi: 10.5501/wjv.v14.i1.98765
Revised: November 4, 2024
Accepted: November 19, 2024
Published online: March 25, 2025
Processing time: 146 Days and 7.5 Hours
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2. It was declared a global pandemic on March 11, 2020, by the World Health Organization. An excessive inflammatory response is a severe respiratory manifestation of COVID-19, which becomes predominant in later stages. Due to its immunosuppressive and anti-inflammatory properties, dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients. This editorial reviews the efficacy and safety of high-dose vs low-dose dexamethasone in patients with COVID-19. Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone. While the study provides a robust evidence base, it is limited by the lack of long-term data, focus on specific outcomes and heterogeneity of the included studies. Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.
Core Tip: This editorial evaluates a meta-analysis comparing high-dose and low-dose dexamethasone in the treatment of coronavirus disease 2019 (COVID-19) patients. The study reveals no significant differences in adverse effects and mortality between the dosing regimens. In line with the current guidelines, the study favors using low-dose dexamethasone but highlights the call for additional research on high-dose dexamethasone’s benefits. The study includes limitations such as a lack of long-term data and heterogeneity of the included studies. It is crucial to address these gaps in the future to optimize treatment strategies for COVID-19.