- previous steroid use 48 hours or more. - pregnancy - chronic respiratory failure - requirements of mechanical ventilation (invasive or no invasive) - chronic liver damage child pugh b or c - chronic kidney disease stage iv or v. - immunosuppressed - participation on other trial.

- previous steroid use 48 hours or more. - pregnancy - chronic respiratory failure - requirements of mechanical ventilation (invasive or no invasive) - chronic liver damage child pugh b or c - chronic kidney disease stage iv or v. - immunosuppressed - participation on other trial.