In this section : Covid-19
Molnupiravir
Sotrovimab
Conscious Proning
Covid-19 Basics
Remdesivir
Thromboprophylaxis
Identifying Patients in the Highest Risk Groups
Steroids for Patients with Covid-19 Infection
IL-6 Inhibitors – Tocilizumab or Sarilumab
Baricitinib
Paxlovid (Nirmatrelvir/Ritonavir)
Covid-19 Sick Day Rules for Patients with Primary Adrenal Insufficiency
Steroids for Patients with Covid-19 Infection
Last updated 26th June 2023
Please ensure you have read the information on the Covid-19 Basics page before proceeding.
Steroids should be prescribed for patients with COVID-19 infection who have a new or increased oxygen requirement to meet target saturations – even if they are unable to have or tolerate supplemental oxygen.
Treatment length is 10 days or until discharge, whichever is sooner.
Treatment Choice
Not pregnant, not already taking oral steroids | Dexamethasone oral or IV, 6mg daily |
Pregnant or breastfeeding | Hydrocortisone IV 50mg three times daily |
Already taking more than 20mg prednisolone daily (or equivalent) | Discuss with Endocrinologist |
Already taking less than 20mg prednisolone daily (or equivalent) | Switch to dexamethasone 6mg daily |
Taking steroid replacement therapy for adrenal insuffuciency | Click here for more information |
- If patient does not require oxygen but is already taking oral steroids, double their dose whilst unwell.
Stopping Treatment
- If oxygenation improves promptly after starting steroids, do not stop the steroids.
- Stop steroids after 10 days or at discharge. Stop sooner if risk outweighs benefit.
Gastric Protection
- Consider prescribing a PPI or H2 antagonist for the duration of treatment.
Blood Sugar Check
- Prescribe blood sugar check on HEPMA for all patients prescribed steroids.
- This should be four times daily for known diabetics, and once daily for other patients.
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Content by Alison Moore