NEW TREATMENTS
June 18, 2020

Help for COVID's Sickest

The steroid dexamethasone is used to reduce inflammation; it can also save the lives of coronavirus patients who can't breathe.

There's a cheap and widely available drug that can help people seriously ill with COVID-19. And it's welcome news.

The drug, dexamethasone, is an anti-inflammatory steroidal medication that has been used since the early 1960s to treat a wide range of conditions including rheumatoid arthritis and asthma.

The drug cut the risk of death by a third for patients in the trial who were on ventilators. For those on oxygen, it cut deaths by a fifth.

Proof of the drug's usefulness in combating the damage that the novel coronavirus causes in some patients comes from The Recovery Trial which has been running since March. It previously found the malaria drug hydroxychloroquine ineffective.

Dexamethasone appears to help the sickest coronavirus patients — people on ventilators or oxygen. It cut the risk of death by a third for patients in the trial who were on ventilators. For those on oxygen, it cut deaths by a fifth.

Half of all COVID patients who require a ventilator do not survive, so cutting that risk by a third would have a huge impact. Had the drug had been used to treat patients in the UK from the start of the pandemic, up to 5,000 lives could have been saved, researchers say. “When appropriate, hospital patients should now be given it without delay,” said lead researcher, Martin Landray, Professor of Medicine and Epidemiology at Oxford University.

Landray does not recommend that people go out and buy it to take at home. Dexamethasone does not appear to help people with milder symptoms of coronavirus who do not need help with their breathing. And estimates are that about 19 out of 20 people with the virus recover without being admitted to the hospital.

The Recovery Trial enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either just standard care or additionally one of several treatments: the HIV combo drug lopinavir-ritonavir, the antibiotic azithromycin; the steroid dexamethasone, the anti-inflammatory drug tocilizumab or plasma from people who have recovered from COVID-19 that may contain antibodies to fight the virus.

Research is continuing on the other treatments.

In the dexamethasone part of the trial, about 2,000 hospital patients were given dexamethasone and compared with more than 4,000 who were not.

Researchers found that for patients on ventilators, dexamethasone reduced the risk of death from 40 percent to 28 percent. For patients needing oxygen, it lowered the risk of death from 25 percent to 20 percent.

The drug appears to work by helping to stop the damage that occurs when a person's immune system goes into overdrive to fight the virus, a response sometimes called a cytokine storm. This creates a condition where the immune system can actually do more harm than the infection itself.

According to Landray, the findings suggest that one life could be saved for every eight patients on a ventilator and every 20-25 treated with oxygen. He estimates that dexamethasone treatment essentially costs £35, about $43, to save a life.

Results were announced June 16 and the researchers hope to publish them soon. The drug has just been approved for use in severely ill coronavirus patients by Britain's National Health Service. The search for a vaccine to protect people from COVID-19 continues.

COMMENTS
NOTE: We regret that we cannot answer personal medical questions.
 
FOLLOW US
© 2016 interMDnet Corporation.