Coronavirus: Steroid reduces death risk in severe virus cases

Henrietta Strickland
June 16, 2020

The RECOVERY trial was launched in April as a randomized clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone and the malaria drug hydoxycholoroquine.

Trials of treatment of anti-arthritis drug hydroxychloroquine were halted in several countries after a major study in The Lancet medical journal suggested it showed no benefit among COVID-19 patients and even increased the risk of death.

The drug was given either orally or through an IV.

Remdesivir, an anti-viral that appears to reduce the length of treatment in some patients is already being used in Britain, but one study in April showed it had "no clinical benefit".

The RECOVERY trial included over 11,500 patients, enrolled from more than 175 hospitals in the United Kingdom, noted a statement by the University of Oxford.

The RECOVERY trial compared outcomes of around 2,100 patients who were randomly assigned to get the steroid, with those of around 4,300 patients who did not get it. Initially thought to be restricted to the respiratory system, scientists now have understood that the COVID-19 also involves multiple other organs, including the central and peripheral nervous system.

A trial launched in March 2020 has released its results, finding that dexamethasone reduced deaths of ventilated COVID-19 patients by one-third.

"This is a drug that is globally available", he said, emphasizing that for every eight patients on ventilators that are treated with the drug, one life could be saved. "It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials".

Peter Horby, professor of emerging infectious diseases at the university's Nuffield Department of Medicine, and one of the chief investigators for the trial, described it as "an extremely welcome result".

Overall dexamethasone reduced the 28-day mortality rate by 17% (0.83 [0.74 to 0.92]; P=0.0007) with a highly significant trend showing greatest benefit among those patients requiring ventilation (test for trend p 0.001).

The drug, according to the scientists, is low-cost, on the shelf, and can be used immediately to save lives worldwide.

Dexamethasone is a cheap and widely-available steroid drug that has become the first medicine shown to be able to save lives of patients severely affected by COVID-19.

Patients given dexamethasone and who were not on a ventilator saw death rates drop by a fifth in comparison to standard care.

Developing a treatment or vaccine for severe COVID-19 is now the world's top public health priority.

Koralnik and colleagues have formed a Neuro-COVID research team and started a retrospective analysis of all COVID-19 patients hospitalized at Northwestern Medicine to determine the frequency and type of neurological complications, as well as response to treatment.

Other reports by Click Lancashire

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