Covid-19: Steroids can help the sickest patients, studies show
Steroids can help the sickest patients, studies show
INTERNATIONAL clinical trials confirm the hope that the cheap, widely available drugs can help seriously ill patients survive. The World Health Organization is expected to release new guidelines encouraging their use.
International clinical trials published on Wednesday confirmed the hope that cheap, widely available steroid drugs can help seriously ill patients survive Covid-19, the illness caused by the coronavirus.
Following release of the new data, the World Health Organization on Wednesday strongly recommended steroids for treatment of patients with severe or critical Covid-19 worldwide. But the agency recommended against giving the drugs to patients with mild disease.
The new studies include an analysis that pooled data from seven randomized clinical trials evaluating three steroids in over 1,700 patients. The study concluded that each of the three drugs reduced the risk of death.
That paper and three related studies were published in the journal JAMA, along with an editorial describing the research as an “important step forward in the treatment of patients with Covid-19.”
Corticosteroids should now be the first-line treatment for critically ill patients, the authors added. The only other drug shown to be effective in seriously ill patients, and only modestly at that, is remdesivir.
Steroids like dexamethasone, hydrocortisone and methylprednisolone are often used by doctors to tamp down the body’s immune system, alleviating inflammation, swelling and pain. Many Covid-19 patients die not of the virus, but of the body’s overreaction to the infection.
The analysis of pooled data found that steroids were linked with a one-third reduction in deaths among Covid-19 patients. Dexamethasone produced the strongest results: a 36 percent drop in deaths in 1,282 patients treated in three separate trials.
In June, researchers at Oxford University discovered that dexamethasone seemed to improve survival rates in severely ill patients. Researchers had hoped that other inexpensive steroids might help these patients.
Taken together, the new studies will bolster confidence in the use of steroids and address any lingering hesitancy on the part of some physicians, said Dr. Todd Rice, an associate professor of medicine and critical care physician at Vanderbilt University School of Medicine.
“This shows us steroids are clearly beneficial in this population and should clearly be given, unless you absolutely can’t for some reason, which needs to be a pretty rare occasion,” he said.
This shows us steroids are clearly beneficialin this population and should clearly be given, unless you absolutely can’t for some reason, which needs to be a pretty rare occasion.