Clinical trial shows common steroid improves recovery and survival for COVID-19 ICU patients

The global study, involving more than 200 intensive care units around the world, has found that delivering intravenous hydrocortisone, a corticosteroid, improves recovery and survival for critically ill COVID-19 patients.

close up of ICU equipment

The findings are reported today in the Journal of the American Medical Association (JAMA) as part of a four-article package. The World Health Organization is updating its COVID-19 treatment guidance as a result.

The Health Research Board helped fund the Irish arm of this trial which was set up by a group of intensive care specialists from around the world. It is led in Ireland by Professor Alistair Nichol, St Vincent’s University Hospital and University College Dublin. Irish hospitals and patients participated in this important trial.

According to Professor Nichol,

'The REMAP CAP Trial was designed to be able to quickly recruit patients in response to emerging pandemics such as COVID-19. So, in March 2020 our team of investigators began randomising patients with COVID-19 to alternative hydrocortisone dosing strategies and compared their outcomes with patients who received no corticosteroid.

The study involved 384 adult participants globally, and the research found a 93 per cent probability that giving this common steroid to patients improved their recovery and survival. The results were consistent across age, race and sex.

These results build on the success of existing evidence that dexamethasone, another corticosteroid, also improves outcomes for COVID 19 patients, confirming that this class of anti-inflammatory drugs can make a real difference in the fight against COVID-19.

Data from REMAP-CAP also contributed by combining data with other corticosteroid trials to confirm these results. Overall, this is an important extension of current knowledge that gives clinicians an alternative corticosteroid to use in case of shortages in availability of dexamethasone'.

Dr Mairead O'Driscoll, Chief Executive at the HRB added,

'This rapid response to address critical cases of COVID 19 is possible as a result of long-term investment by the Health Research Board in both the Irish Critical Care Clinical Trials Network at the UCD Clinical Research Centre, and in clinic research infrastructures across in Ireland. It is good to see that by having this infrastructure in place, we can help deliver such timely and relevant outcomes for patients with COVID-19’.

Since 2007, the HRB has invested more than €160 million in Ireland's clinical research ecosystem.

The paper to which Dr Nichol contributed, titled Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19, is published today in JAMA as part of a four-article package.



To set up an interview with Prof Nichol, please contact Stephen Pigott, Marketing and Communications Manager, UCD School of Medicine. Mobile: +353 87 646 2128

For a press pack on all four articles featured in the JAMA press package, please contact the JAMA Network Media Relations staff, t + 312-464-5262, e