Dexamethasone, a cheap steroid, reduced deaths by one-third in ventilated patients and by one fifth in other patients receiving oxygen only. There was no benefit among those patients who did not require respiratory support.
A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).
Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.
Dexamethasone is a medical staple found on pharmaceutical shelves worldwide and is available as a pill — a particular benefit as coronavirus infections continue to rise in countries with limited access to healthcare. “For less than £50 ($63), you can treat 8 patients and save one life,” said Martin Landray, an epidemiologist at the University of Oxford.
The antiviral drug remdesivir was previously shown to shorten the amount of time that patients may need to spend in the hospital, it did not have a statistically significant effect on death.
The combination of remsesivir and Dexamethasone can now be used to lessen the load on hospitals and save lives of the sickest people with COVID-19.
Dexamethasone is already used to reduce inflammation in a range of other conditions. It appears to help stop some of the damage that can happen when the body’s immune system goes into overdrive as it tries to fight off coronavirus. This over-reaction, a cytokine storm, can be deadly.
Half of all Covid patients who require a ventilator do not survive, so cutting that risk by a third would have a huge impact.
SOURCES- Nature, Oxford, BBC News
Written By Brian Wang, Nextbigfuture.com