Cheap drug improves COVID survival
Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid reduced deaths by up to one third in severely ill hospitalized patients.
The results were announced Tuesday and the British government immediately authorized the drug’s use across the United Kingdom for coronavirus patients like those who did well in the study.
Researchers said they would publish results soon in a medical journal, and several independent experts said it’s important to see details to know how much of a difference the drug, dexamethasone, might make and for whom.
But “bottom line is, good news,” said the United
States’ top infectious disease expert, Dr. Anthony Fauci. “This is a significant improvement in the available therapeutic options that we have.”
The study, led by the University of Oxford, was a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care.
After four weeks, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients.
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.
“Those are big effects,” said one study leader, Dr. Martin Landray at Oxford. “It’s not a cure, but it’s certainly a long way forward.”
Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection.
This overreaction damages the lungs and can prove fatal.
The World Health Organization and others advise against using steroids earlier in the course of illness because they can impede clearing the virus.
“Early on, you’re fighting the virus and you want your immune system to be as intact as possible,” Fauci explained. But in the advanced stage of COVID19, the battle against the virus causes so much inflammation that it “is hurting you more than helping you,” he said.
Although the Oxford researchers talked only about dexamethasone, the detailed plans for the study say that participating hospitals could use two other steroids — prednisolone or hydrocortisone — and there’s no reason to think any particular one works better than another, said Dr. Francisco Marty, an infectious disease specialist at
Brigham and Women’s Hospital in Boston.
“I assume the majority of people used dexamethasone, but it’s not the only one that people could have used,” he said. “It will be great to see the data to see if there’s a class effect.”