The medical world is buzzing with the recent news concerning the World Health Organisation’s RECOVERY trial. Scientists involved in the trial have reported a promising development: dexamethasone, a widely available and inexpensive steroid drug, has shown efficacy in reducing deaths among severely ill Covid-19 patients. This article delves into the details of this significant finding, its implications, and reactions.
Key Points from the Research
Administered either orally or through intravenous infusion (IV), dexamethasone exhibited significant results after 28 days of treatment. The drug was found to reduce deaths by 35% in patients requiring treatment with breathing machines and by 20% in those needing only supplemental oxygen. It should be noted that this drug did not show benefits for less ill patients or those not requiring respiratory support.
Estimates suggest that dexamethasone can prevent one death for every eight patients on breathing machines and one for every 25 patients on extra oxygen alone.
How Dexamethasone Works
A Covid-19 related illness, Multi-system Inflammatory State, results in inflammation of the blood vessels leading to low blood pressure. This condition severely affects the entire body as it causes buildup of fluid in the lungs and other organs. Such inflammation could be fatal and requires intervention with steroids or other anti-inflammatory drugs.
Interestingly, dexamethasone is not an anti-viral drug. Rather, it modulates the immune response of the body when faced with a viral infection like Covid-19.
The Benefits of Dexamethasone
Among severe patients, the survival benefit of dexamethasone is clear and substantial. It is highly affordable and easy to produce. Moreover, production can be scaled up quickly, and the required dosage is small. Compared to tocilizumab, an injectable drug also being tested, dexamethasone presents a more cost-effective option.
Concerns Associated with Dexamethasone
The World Health Organisation (WHO) advises against early use of steroids in a disease course as they can delay the time until patients clear the virus. Excessive use of steroids can lead to serious side effects including major mood swings, aggression and irritability, delusions, damage to the kidneys or liver, and increased blood pressure.
Reaction in India
In India, doctors have hailed this research as beneficial news for Covid-19 patients on ventilators. The drug is both affordable and readily available in the country. Previously, the Indian Council for Medical Research (ICMR) revised the protocol for clinical management of Covid-19 allowing the use of remdesivir, tocilizumab, and Convalescent Plasma Therapy (CPT) on certain patient groups.
Other Findings from the Research
This same study concluded earlier that the malaria drug hydroxychloroquine was ineffective against the coronavirus. Over 11,000 patients across England, Scotland, Wales, and Northern Ireland participated in the study. These patients received either standard care or that plus one of the following treatments: dexamethasone, HIV combination drug lopinavir-ritonavir, antibiotic azithromycin, anti-inflammatory drug tocilizumab, or plasma from individuals who had recovered from Covid-19, containing antibodies to combat the virus.
Last Modified: February 7, 2024