Coronavirus: Steroid dexamethasone can help save worst-hit patients

James Marshall
June 17, 2020

Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said, "Dexamethasone is the first drug to be shown to improve survival in COVID-19".

For patients on ventilators, the risk of death dropped from 40% to 28%, and for those on oxygen it dropped from 25% to 20%.

No treatment for COVID-19 - the disease caused by the new coronavirus and which has killed more than 431,000 people globally - has been shown to reduce the mortality of the disease, although Gilead Sciences Inc's remdesivir shortened the recovery time for hospital patients.

For patients on oxygen, it cuts the chances of death from coronavirus by a fifth.

It's understandable that these researchers would want to get the news out as soon as possible, given the possibility that dexamethasone could, based on the results, save lives immediately.

Britain will immediately start giving dexamethasone to coronavirus patients, after a trial showed the steroid saved the lives of one third of the gravest cases, Health Secretary Matt Hancock said Tuesday.

Meanwhile, the drug also seemed to benefit patients who required oxygen assistance without mechanical ventilation, reducing deaths in this group by about 20%. "Dexamethasone is affordable, on the shelf, and can be used immediately to save lives worldwide", said Peter Horby, professor of emerging infectious diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial.

The dexamethasone research was part of a larger study, called Recovery, that compares a number of potential treatments in an attempt to quickly identify those that are most effective.

The discovery was made during a major trial to find a treatment for the coronavirus, that examines existing treatments. The scientists working on the trial are looking to publish their results shortly and are already sharing their findings with regulators internationally.

But dexamethasone showed no benefit among patients who did not require respiratory support (RR 1.22, 95% CI 0.86-1.75). That's an exacerbated response from the immune system that can attack healthy tissue. And now, as the BBC reports, the Oxford team is releasing their "major breakthrough" about the drug via the initial results of a study of 6,000 COVID patients.

The NHS will make dexamethasone available as treatment for patients on ventilators and oxygen from Tuesday afternoon.

The U.K. has stockpiled more than 200,000 courses of dexamethasone after spotting its potential, Hancock said.

"This is the dream", because the drug has been used for decades for other conditions, said Cammack, who had no role in the study. "Dexamethazone is readily available and expensive and would be available for treatment on a global basis right away".

The trial is testing a range of established and promising treatments including: lopinavir-ritonavir, low-dose dexamethasone (a type of steroid, which typically used to reduce inflammation), hydroxychloroquine (since stopped due to lack of efficacy), azithromycin, tocilizumab and convalescent plasma, containing SARS-CoV-2 antibodies collected from recovered COVID-19 donors.

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