Dexamethasone Improves Cardiovascular Outcomes in Critically Ill COVID-19, a Real World Scenario Multicenter Analysis

Peter Jirak, Vincent van Almsick, Dimitrios Dimitroulis, Moritz Mirna, Clemens Seelmaier, Zornitsa Shomanova, Bernhard Wernly, Dilvin Semo, Daniel Dankl, Magdalena Mahringer, Michael Lichtenauer, Uta C. Hoppe, Holger Reinecke, Rudin Pistulli, Robert Larbig, Lukas J. Motloch

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Severe COVID-19 pneumonia requiring intensive care treatment remains a clinical challenge to date. Dexamethasone was reported as a promising treatment option, leading to a reduction of mortality rates in severe COVID-19 disease. However, the effect of dexamethasone treatment on cardiac injury and pulmonary embolism remains largely elusive. Methods: In total 178 critically ill COVID-19 patients requiring intensive care treatment and mechanical ventilation were recruited in three European medical centres and included in the present retrospective study. One hundred thirteen patients (63.5%) were treated with dexamethasone for a median duration of 10 days (IQR 9–10). Sixty five patients (36.5%) constituted the non-dexamethasone control group. Results: While peak inflammatory markers were reduced by dexamethasone treatment, the therapy also led to a significant reduction in peak troponin levels (231 vs. 700% indicated as relative to cut off value, p = 0.001). Similar, dexamethasone resulted in significantly decreased peak D-Dimer levels (2.16 mg/l vs. 6.14 mg/l, p = 0.002) reflected by a significant reduction in pulmonary embolism rate (4.4 vs. 20.0%, p = 0.001). The antithrombotic effect of dexamethasone treatment was also evident in the presence of therapeutic anticoagulation (pulmonary embolism rate: 6 vs. 34.4%, p < 0.001). Of note, no significant changes in baseline characteristics were observed between the dexamethasone and non-dexamethasone group. Conclusion: In severe COVID-19, anti-inflammatory effects of dexamethasone treatment seem to be associated with a significant reduction in myocardial injury. Similar, a significant decrease in pulmonary embolism, independent of anticoagulation, was evident, emphasizing the beneficial effect of dexamethasone treatment in severe COVID-19.

Original languageEnglish
Article number808221
JournalFrontiers in Medicine
StatePublished - 2 Feb 2022
Externally publishedYes


  • COVID-19
  • anticoagulation
  • cardiac injury
  • dexamethasone
  • pulmonary embolism


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