The Atlanta Journal-Constitution
WHO backs steroids for severe COVID-19
Cheap, widely available steroid drugs reduced the number of deaths in the sickest patients with COVID-19, shows a trio of newly published clinical trials.
What happened
The World Health Organization, citing evidence from these and similar trials, announced Wednesday it strongly recommends doctors use the medications to combat severe or critical forms of disease caused by coronavirus infections.
Finding a treatment that saves lives is “electrifying ... it gives us hope. Maybe we’re gaining on this virus,” said Todd W. Rice, a critical care physician at Vanderbilt University Medical Center not involved in the studies.
WHO’s decision brings the international agency in line with the U.S. National Institutes of Health, which earlier this summer recommended use of a synthetic steroid, dexamethasone, to treat hospitalized patients who require ventilators or oxygen.
Why it happened
The evidence that persuaded the WHO included a meta-analysis, sponsored by the organization, which evaluated three new studies, plus four other randomized, controlled trials. Each trial involved a medication from the family of anti-inflammatory drugs called corticosteroids.
“These three trials, and then the World Health Organization meta-analysis, sets steroids as the standard and the expectation that patients are critically ill will get treated with this,” Rice said.
The details
The WHO review concluded corticosteroids reduced deaths in critically ill patients by 20% — a drop from 2 deaths per 5 patients to 1 in 3. It found that another steroid, hydrocortisone, had benefits on par with those of dexamethasone.
“Corticosteroids are the only treatment that has been conclusively demonstrated to reduce mortality in patients with COVID-19,” said Jonathan Sterne, an author of the meta-analysis and an expert in medical statistics at Britain’s University of Bristol.
“These results strengthen the evidence that doctors should treat critically ill COVID-19 patients with corticosteroids, unless there is a strong reason not to do so based on the circumstances of the individual patients,” he said.
Dexamethasone was the first medication shown to increase the odds of survival in patients with severe COVID-19 when the initial outcomes from a British clinical trial, named Recovery, were published in June.
The similar benefits shown by these new studies were a welcome confidence boost to doctors who had been using corticosteroids to treat patients based on the earlier results.