Study suggests common steroid can reduce coronavirus deaths

In a hopeful sign of progress amid an expanding pandemic, scientists at the University of Oxford said on Tuesday that an inexpensive and commonly available drug reduced deaths in patients with severe COVID-19, the illness caused by the coronavirus.

If the finding is borne out, the drug, a steroid called dexamethasone, would be the first treatment shown to reduce mortality in the sickest patients. Had doctors been using the drug to treat the sickest COVID-19 patients in Britain from the beginning of the pandemic, up to 5,000 deaths could have been prevented, the researchers estimated.

In severe cases, the virus directly attacks cells lining the patient’s airways and lungs. But the infection also can prompt an overwhelming immune reaction that is just as harmful. Threequarters of hospitalized COVID-19 patients receive some form of oxygen.

The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

Until now, hospitals worldwide have had nothing to offer these desperate, dying patients.

“Assuming that when it goes through peer review it stands — and these are well-established researchers — it’s a huge breakthrough, a major breakthrough,” said Dr. Sam Parnia, a pulmonologist and associate professor of medicine at the Grossman School of Medicine at New York University.

No American hospitals were involved in the drug study and U.S. doctors have been wary of the use of steroids in COVID-19 care, said infectious disease expert Dr. Peter Chin-Hong of UC San Francisco, who helps evaluate the medical center’s use of therapeutics. Doctors fear dangerous side effects in patients with diabetes, he said. They also worry that immunosuppression could worsen a viral infection.

The drug will not be considered for use at UC San Francisco’s three hospitals until the research is published in a peer-reviewed journal, said Chin-Hong. “We want to look at paper,” he said. “People are feeling burned by the last two retractions” of influential studies in The Lancet and New England Journal of Medicine, two of the world’s top medical journals.

There are important questions that must be answered before UCSF would consider use of the medicine, said Chin-Hong. Were their patients similar to ours, in age, ethnicity and health condition? When was treatment started? Are there biases in study design? Additionally, use of the drug could compromise a patient’s ability to join clinical trials of other medicines, he said.