Dexamethasone in Hospitalized Patients with Covid-19
· paper · Clinical trials
A randomized open-label trial comparing dexamethasone with usual care in 6,425 patients hospitalized with Covid-19. Dexamethasone lowered 28-day mortality among patients on ventilation or oxygen, but not among those needing no respiratory support.
Checked: PDF from europepmc.org, fetched 4 Oct 2026. Page numbers are those of that PDF.
3 findings
Substance The age-adjusted absolute reduction in 28-day mortality for patients on oxygen only is "4.2 percentage points (95% CI, 1.4 to 6.7)" in the Results (p7) but "by 4.1 age-adjusted percentage points" in the Discussion (p8).
- p. 7 Results, Primary Outcome, text below Figure 2 (right column)
4.2 percentage points (95% CI, 1.4 to 6.7) among those receiving oxygen only
- p. 8 Discussion, first paragraph
by 4.1 age-adjusted percentage points
- p. 8 Discussion, first paragraph
(by 4.1 age-adjusted percentage points, a proportional reduction of approximately one fifth)
Only the authors can say what is right here.
Judge's note: Page images p7 and p8 confirm both figures. Both passages describe the same quantity: the age-adjusted absolute reduction in 28-day mortality among patients receiving oxygen without invasive mechanical ventilation. The companion value for invasive ventilation (12.3) is identical in both places. The crude difference, 26.2 - 23.3 = 2.9, matches neither figure. I found no erratum in the files. Only the authors can say which value is correct.
Second check: another model agreed
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Reference or label The supplementary appendix states the CRP threshold for the second randomization as "C-reactive protein ≥75 mg/dL", but the protocol (V6.0) and SAP give "≥75 mg/L".
- p. 21 Supplementary Methods, Protocol changes paragraph
C-reactive protein ≥75 mg/dL
- p. 37 Protocol V6.0, second randomisation eligibility
C-reactive protein ≥75 mg/L
- p. 74 SAP v1.0, Second randomisation for patients with progressive COVID-19
C-reactive protein (CRP) ≥75 mg/L
- p. 22 Table footnote a
C-reactive protein ≥75 md/dL)
Judge's note: The supp-03 p21 image shows 'mg/dL'. The supp-04 p37 protocol image shows '≥75 mg/L', and the SAP on p74 also uses mg/L. The unit is wrong by a factor of 10 (75 mg/dL = 750 mg/L), so it should read mg/L. The 'md/dL' footnote misprint is handled separately in C007.
Second check: another model agreed
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Reference or label Footnote a to the protocol-changes table reads "C-reactive protein ≥75 md/dL)" in both supp-03 p22 and supp-04 p63; 'md/dL' is not a unit, and the protocol specifies mg/L.
- p. 22 Table 'Protocol changes to treatment comparisons', footnote a
C-reactive protein ≥75 md/dL)
- p. 63 Substantial amendments to RECOVERY trial protocol, footnote a
C-reactive protein ≥75 md/dL)
Judge's note: Both page images show 'md/dL'. This is a misprint of the unit, and even read as mg/dL it disagrees with the protocol's ≥75 mg/L (supp-04 p37). It is distinct from C006, which concerns the running text on supp-03 p21.
Second check: another model agreed
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17 minor (typos and the like; most checked by the judge only)
Wording SAP section 2.6.3 (supp-04 p74) lists "Serious cardiac arrhythmia (recorded in a subset)", but the analysis section 5.1.3.3 and the table of contents call the outcome "Major cardiac arrhythmia".
- p. 74
Serious cardiac arrhythmia (recorded in a subset)
Judge's note: The crop shows "Serious cardiac arrhythmia (recorded in a subset)" under 2.6.3. A text-layer search finds "Major cardiac arrhythmia" in the SAP contents, in heading 5.1.3.3 and in its body text, and "new major cardiac arrhythmia" in the protocol. This looks like one outcome given two labels, which is a minor terminology inconsistency inside the SAP.
Second check: another model agreed
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Wording SAP 5.1.3.1 (supp-04 p80) lists causes of death as "(COVID-19, other infection, cardiovascular and other)", but section 2.6.3 lists "Cause-specific mortality (COVID-19; cardiovascular; non-vascular; other)".
- p. 80
(COVID-19, other infection, cardiovascular and other)
Only the authors can say what is right here.
Judge's note: Both crops confirm the two category lists. Section 5.1.3.1 adds "other infection" and leaves out "non-vascular", while section 2.6.3 does the reverse. Only the authors can say which set of categories is intended.
Second check: another model agreed
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Typo The funding statement says "Dr. Fenton by the NIHR Manchester Biomedical Research Centre", but the writing-committee member is "Timothy Fel-ton" (T.F., Manchester).
- p. 10 Funding/acknowledgment paragraph
Dr. Fenton by the NIHR Manchester Biomedical Research Centre
- p. 1 Writing committee list
Timothy Fel-ton, Ph.D.
Judge's note: The p10 image shows 'Dr. Fenton'. The byline on p1 lists Timothy Felton, and the appendix affiliations give T.F. at Manchester. 'Fenton' appears nowhere else in the article, so this is a misspelling of Felton.
Second check: none (judge only)
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Typo Misspelling in the protocol randomisation form list: "Major cormorbidity (e.g. heart disease, diabetes, chronic lung disease)" should read "comorbidity".
- p. 10
Major cormorbidity (e.g. heart disease, diabetes, chronic lung disease)
Judge's note: The supp-04 p10 page image shows "cormorbidity" in the bullet list, so the misspelling is in the published document.
Second check: none (judge only)
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Typo Ungrammatical phrase in the protocol: "in the context of this trial they are generally would not influence the reliability" mixes two verb forms ("are" and "would").
- p. 15
they are generally would not influence the reliability
Judge's note: The supp-04 p15 page image (protocol page 11 of 22) shows the phrase as quoted. Deleting "are" or rephrasing would fix it.
Second check: none (judge only)
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Typo Extra word in the protocol: "CCO staff will use be responsible for provision of the relevant web-based applications"; "use" should be removed.
- p. 16
CCO staff will use be responsible for provision
Judge's note: The supp-04 p16 page image shows "will use be responsible" as quoted.
Second check: none (judge only)
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Typo A disclosure form gives the company name as "Boehringer Ingleheim".
- p. 20
Boehringer Ingleheim
Only the authors can say what is right here.
Judge's note: Rests on outside knowledge: the company's name is spelled 'Boehringer Ingelheim'. The supp-02 p20 image shows 'Ingleheim' as printed. This is a cosmetic error in a disclosure form.
Second check: none (judge only)
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Typo Supp-04 p20 (protocol Appendix 1) prints "Parentral IFN-β1a has been licensed"; this should be "Parenteral".
- p. 20
Parentral IFN-a has been licensed
Judge's note: I opened the full page image. The paragraph begins "Parentral IFN-β1a has been licensed for use in multiple sclerosis since 1996". The reviewer's quote has "IFN-a", but the page shows β1a. The misspelling of "Parenteral" is real.
Second check: none (judge only)
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Typo The table of randomisation-form modifications reads "Hydroxycholoroquine added as treatment".
- p. 22 Randomisation form modifications table, version 2.0
Hydroxycholoroquine added as treatment
Judge's note: The supp-03 p22 image shows the misspelling. It should be 'Hydroxychloroquine', as spelled elsewhere in the document.
Second check: none (judge only)
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Typo A disclosure form gives the company name as "Seqrius".
- p. 24
Seqrius
Only the authors can say what is right here.
Judge's note: Rests on outside knowledge: the company's name is spelled 'Seqirus'. The supp-02 p24 image shows 'Seqrius' as printed. This is a cosmetic error in a disclosure form.
Second check: none (judge only)
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Typo A Table S3 row header reads "SARS-Cov-2 test result", whereas elsewhere the supplement writes SARS-CoV-2.
- p. 34 Table S3 row header
SARS-Cov-2 test result
Judge's note: The supp-03 p34 image shows 'SARS-Cov-2'. The other occurrences in supp-03 (text lines 1285 and 1436) use 'SARS-CoV-2'. This is a cosmetic capitalisation inconsistency.
Second check: none (judge only)
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Typo Supp-04 p41 prints "Adjustment for multiple treatment comparisions due to the multi-arm design"; this should be "comparisons".
- p. 41
multiple treatment comparisions due to the multi-arm design
Judge's note: The crop shows "comparisions" exactly as quoted.
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Typo Supp-04 p45 prints "CCO staff will use be responsible for provision of the relevant web-based applications"; the word "use" is extra.
- p. 45
CCO staff will use be responsible for provision
Judge's note: The crop shows "will use be responsible" exactly as quoted.
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Typo Supp-04 p45 prints "(but should mindful of the workload facing participating hospitals"; the word "be" is missing.
- p. 45
(but should mindful of the workload
Judge's note: The crop shows "but should mindful of the workload" exactly as quoted.
Second check: none (judge only)
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Typo Supp-04 p47, in the version 3.0 row of the protocol version history, prints "Addition of inclusion of adults who lack permanently lack capacity."; the word "lack" appears twice.
- p. 47
Addition of inclusion of adults who lack permanently lack capacity.
Judge's note: The crop of the version table shows the duplicated "lack" in the version 3.0 row.
Second check: none (judge only)
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Typo Supp-04 p49 prints the bold heading "Hydroxycholoroquine:"; this should be "Hydroxychloroquine".
- p. 49
Hydroxycholoroquine: Chloroquine (CQ), an antimalarial
Judge's note: The crop shows the bold heading "Hydroxycholoroquine:". The same paragraph spells "hydroxychloroquine" correctly further on.
Second check: none (judge only)
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Typo Supp-04 p49 prints "The dose in RECOVERY is Hydroyxchloroquine (155mg base per 200 mg tablet)"; this should be "Hydroxychloroquine".
- p. 49
Hydroyxchloroquine (155mg base per 200 mg tablet)
Judge's note: The crop shows "Hydroyxchloroquine" with the letters transposed. The paragraph just above spells "Hydroxychloroquine" correctly.
Second check: none (judge only)