Extended-duration dexamethasone for the treatment of hospitalized COVID-19 patients in Canada: A randomized clinical trial
Bibliographic record
Abstract
The optimal duration of corticosteroid therapy in hospitalized COVID-19 patients remains uncertain. While a 10-day course of dexamethasone reduces mortality, the benefit of extending treatment in patients who continue to require oxygen is unknown. This open-label randomized trial was conducted as part of the Canadian Treatments for COVID-19 (CATCO) trial, the Canadian arm of the WHO Solidarity trial. Between January 19 and October 4, 2022, hospitalized COVID-19 patients who had completed 10 days of dexamethasone and remained on supplemental oxygen were randomized to receive either extended dexamethasone treatment or standard care. The primary outcome was the WHO ordinal scale at day 28. Secondary outcomes included in-hospital and 90-day mortality, oxygen and ventilation requirements, and hospital length of stay. Eleven patients were enrolled across five Canadian sites before early termination due to declining admissions. Median WHO scores at day 28 were similar between groups. One patient in the standard care group required new oxygen therapy; no patients required mechanical ventilation. One patient in the extended group died during hospitalization; by day 90, two had died in the extended group and none in the standard care group. In this small randomized controlled trial, we cannot determine effectiveness of extended dexamethasone for hospitalized patients with COVID-19 who require oxygen after 10 days of therapy. Larger, adequately powered trials are needed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".