WHO updates clinical care guidance with corticosteroid recommendations

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On 2 September, WHO published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with COVID-19. 

We recommend systemic corticosteroids for the treatment of patients with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful. Treatment should be under the supervision of a clinician.

Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost.  WHO encourages countries to maintain sufficient stocks of corticosteroids to treat COVID-19 and the other disease for which they are effective, while not maintaining excessive stocks which could deny other countries access. 

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This guidance was developed in collaboration with the non-profit Magic Evidence Ecosystem Foundation (MAGIC), which provided methodologic support to develop and disseminate living guidance for COVID-19 drug treatments. 

Work on this guidance began on 22 June when the RECOVERY trial published a preliminary report on the impact of corticosteroids. To supplement the results, WHO partnered with investigators of seven trials on corticosteroids to conduct a meta-analysis of these trials, in order to rapidly provide additional evidence to build on RECOVERY data and inform guidance development. 

The guidance was thus informed by combining data from eight randomized trials of systemic corticosteroids for COVID-19. 

WHO provides guidance that works across all contexts for all countries and health care systems. 

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