Dexamethasone and similar steroids now are known to improve survival when used in hospitalized patients who need extra oxygen, but might be harmful for less sick patients.
The World Health Organization says dexamethasone is not recommended for non-severe cases; the National Institutes of Health guidelines only recommend dexamethasone for patients with COVID-19 who are on a ventilator or are receiving supplemental oxygen.
The National Institutes of Health COVID-19 treatment guidelines recommend against using dexamethasone in patients who do not require oxygen. It has only been proven to help in more serious cases. Among the concerns with earlier use is that steroids tamp down certain immune cells, hindering the body’s own ability to fight off infection.