Steroids seen as helpful in severe virus cases
Cheap and easily accessible steroids can improve survival for severely ill coronavirus patients, a treatment guideline that the World Health Organization is now recommending.
“The bottom line is all the data, when viewed together, are consistent and show that we can help severely ill and critically ill patients by giving them steroids,” said Dr. Daniel Kuritzkes, chief of infectious disease at Brigham and Women’s Hospital, who was not involved with the steroids study.
Steroids reduced the risk of death in the first month by about one-third compared to placebo treatment or usual care alone in seriously ill COVID patients who needed extra oxygen, an analysis of pooled results from seven studies, led by the World Health Organization and published Wednesday by the Journal of the American Medical Association, showed.
Steroid drugs are inexpensive, widely available and have been used for decades. They reduce inflammation, which sometimes develops in coronavirus patients as the immune system overreacts to fight the infection, which can be fatal.
“A lot of the lung injury that occurs in COVID-19 is because of the inflammatory response to the virus, not just the viral infection of lung cells directly,” Kuritzkes said.
The WHO issued updated treatment advice Wednesday recommending steroids for patients with severe COVID-19.
The organization strongly recommends corticosteroid therapy such as dexamethasone or hydrocortisone for 7 to 10 days in patients with severe and critical COVID-19.
“Systemic corticosteroids probably reduce 28day mortality in patients with critical COVID-19 and also in those with severe disease,” the WHO guidelines state.
Another benefit of steroids is the low risk they offer, with limited significant side effects to the patient.
Kuritzkes said although the findings are encouraging, “It’s not a cure.”
He said some questions remain, such as which dosage of steroids works best and when the right time is to give the treatment to the patient.
Another important finding in the research is that steroids are not helpful for people who have less severe cases of coronavirus, and could even prove to be harmful in those cases.
Kuritzkes said it isn’t completely known why, but steroids interfere with the immune system, and for those with more mild cases, that interference may not be necessary.
‘The bottom line is all the data ... are consistent and show that we can help severely ill and critically ill patients by giving them steroids.’ DR. DANIEL KURITZKES chief of infectious disease at Brigham and Women’s Hospital