Dexamethasone reduces death risk in severe COVID-19 cases: Trial

Steroid cuts risk of death by a third for patients on ventilators, by a fifth for those on oxygen, researchers say.

    Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone [File: Athit Perawongmetha/Reuters]
    Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone [File: Athit Perawongmetha/Reuters]

    Dexamethasone, a cheap and widely used steroid, has been found to dramatically reduce the risk of dying from COVID-19, the disease caused by the new coronavirus, in what scientists in the United Kingdom have hailed as a "major breakthrough".

    Researchers led by a team from the University of Oxford administered dexamethasone, which is used to reduce inflammation in other diseases, to more than 2,000 severely ill COVID-19 patients.

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    Among those who could only breathe with the help of a ventilator, the drug reduced deaths by 35 percent, and by one-fifth in other patients receiving oxygen only, according to preliminary results of the Recovery Trial. There was no benefit among the patients who did not require respiratory support.

    "Based on these results, one death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone," a University of Oxford statement said.

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    The results suggest dexamethasone, which is available at pharmacies, should immediately become standard care in patients with severe cases of the disease, according to the researchers.

    "This is an extremely welcome result," one study leader, Peter Horby of the University of Oxford, said in a statement.

    "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."

    The trial results are particularly promising as about 40 percent of COVID-19 patients who require a ventilator end up dying, often because of the body's uncontrolled inflammatory response to the virus.

    For those receiving the new treatment, the mortality rate dropped to less than 30 percent.

    Even though the drug only helps in severe cases, "countless lives will be saved globally", said Nick Cammack of Wellcome, a British charity that supports scientific research.

    "Dexamethasone must now be rolled out and accessed by thousands of critically ill patients around the world," said Cammack, who had no role in the study. "It is highly affordable, easy to make, can be scaled up quickly and only needs a small dosage."

    Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection. This overreaction can prove fatal, so doctors have been testing steroids and other anti-inflammatory drugs in such patients.

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    "This is a result that shows that if patients who have COVID-19 and are on ventilators or are on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost," said Martin Landray, an Oxford University professor co-leading the trial.

    "It's going to be very hard for any drug really to replace this, given that for less than 50 pounds ($63.26), you can treat eight patients and save a life," he told reporters in an online briefing.

    England's chief medical officer, Chris Whitty, said Tuesday's announcement was "the most important trial result for COVID-19 so far", adding: "It will save lives around the world."

    The World Health Organization (WHO) advises against using steroids earlier in the course of illness because they can slow the time until patients clear the virus.

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

    The hydroxychloroquine arm was halted earlier this month after Horby and Landray said results showed it was "useless" in treating COVID-19 patients.

    Global cases of infection with the novel coronavirus have exceeded eight million while the related death toll has surged past 434,000.

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