COVID-19

Cheap, Common Steroid Reduces COVID-19 Mortality Rates

A cheap, common steroid could help to reduce mortality rates among patients with severe cases of COVID-19, with as many as 1 in 8 deaths in ventilated patients being prevented, according to the preliminary results of a recent study.1

The Randomised Evaluation of COVid-19 thERapY (RECOVERY) trial was established in March 2020 for the purpose of exploring various options for treatment of COVID-19. The trial’s dexamethasone arm included 2104 patients randomly assigned to receive dexamethasone 6 mg once per day for 10 day and 4321 patients assigned to usual care.

Overall, the researchers found that death rates among ventilated patients who received dexamethasone were lowered by one-third (rate ratio [RR] 0.65, 95% confidence interval 0.48 to 0.88; p=0.0003), while rates among patients requiring oxygen were lowered by one-fifth (RR 0.80, 95% confidence interval 0.67 to 0.96; p=0.0021). However, no benefits to patients who did not require respiratory support were observed (RR 1.22, 95% confidence interval 0.86 to 1.75; p=0.14).

These results were released on June 16, 2020, in a press release. “Given the public health importance of these results, we are now working to publish the full details as soon as possible,” the chief investigators wrote.

“Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result,” said Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the trial’s Chief Investigators, in the press release.  

“The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

In a press release on June 17, 2020, the World Health Organization announced that it plans to update its guidelines for the treatment of COVID-19 to reflect these results.2

“WHO will coordinate a meta-analysis to increase our overall understanding of this intervention. WHO clinical guidance will be updated to reflect how and when the drug should be used in COVID-19,” they wrote.

—Michael Potts

Reference:

  1. Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19. News release. Oxford University: Recovery Trial; June 16, 2020. https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19
  2. WHO moves to update COVID-19 guidance after 'great news' in drug study. News release. Reuters; June 17, 2020. https://www.reuters.com/article/us-health-coronavirus-steroid-who-idUSKBN23O0LU