Cheap Steroid Reduces Death In Severe Covid-19

August 22, 2020

British researchers announced today (June 16) that a steroid called dexamethasone reduced mortality in hospitalized patients with severe COVID-19 infection in a large clinical trial. One caveat: data from the trial have not yet been released and have not undergone scientific review.

According to the Associated Press, leaders of the randomized evaluation of COVID-19 therapies (RECOVERY) trial, based on the British study, said they will release the data soon. The trial included thousands of patients, 2,104 of whom were randomly assigned to receive 6 milligrams of dexamethasone daily for 10 days, according to Stat News. Another 4,321 received standard care and served as a comparison point for the treatment group.

According to Stat News, steroids showed the greatest benefit in patients who required oxygen, either through ventilation or less invasive methods, but showed no benefit in patients who did not require oxygen. In patients requiring ventilators, dexamethasone reduced mortality by 35 percent. In patients who received supplemental oxygen but were not ventilated, the drug reduced mortality by 20 percent. These rates were calculated 28 days after treatment began, according to the Associated Press.

“Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives around the world,” lead researcher Peter Hobby, a professor at Oxford University’s Nuffield Department of Medicine, said in a statement released by the research team.

“It’s very affordable, easy to make, can be scaled up quickly and only requires a very small dose,” Nick Cammack of Wellcome, a U.K.-based charity that supports scientific research and was not involved in the study, told the Associated Press.

Dexamethasone can be taken orally or intravenously and works by reducing inflammation in the body and suppressing the immune system, according to Drugs.com. Generic steroids are used to treat a wide variety of conditions, from psoriasis to rheumatoid arthritis, asthma and some cancers, including leukemia, according to the National Cancer Institute.

The World Health Organization recommends against using steroids in the early stages of COVID-19 infection because they may hinder the immune system’s attempts to clear the virus from the body, according to the Associated Press. However, during the later stages of a severe infection, dexamethasone may help counteract an over-exaggerated immune response called a cytokine storm – a condition in which inflammatory chemicals flood the body and begin to damage tissues, rather than just targeting the virus. When this attack reaches the lungs, it can trigger acute respiratory distress syndrome, or ARDS, which causes fluid to build up in the air sacs of the lungs, according to Stat News.

Horby said that dexamethasone should now be standard treatment for COVID-19 patients who need oxygen, according to Stat News. But again, study data has not yet been released.

“It would be good news if dexamethasone, an inexpensive steroid, actually reduced mortality [by a third] in ventilated COVID19 patients, but after all the retractions and backtracking, it’s unacceptable to publicize the results of the study through a press release without a published paper,” said Atul Gawande, a surgeon, author and public health researcher tweeted on June 16.

In an interview with CNBC, former FDA commissioner Scott Gottlieb said, “I think it needs to be validated, but it certainly suggests that it could be beneficial in this environment”, according to Statistical News.