World Health Organisation’s RECOVERY trial have reported that dexamethasone reduced Covid-19 deaths in severe patients.
Dexamethasone is a type of corticosteroid medication. It is used in the treatment of many conditions, including rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive lung disease, croup, brain swelling, eye pain following eye surgery, and along with antibiotics in tuberculosis.
Dexamethasone is a cheap and widely available steroid drug.
Highlights of the Research
- The drug was given either orally or through an IV (intravenous).
- After 28 days, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen.
- The drug is not helpful for less ill patients and for those who do not need respiratory support.
- According to the estimates, this drug can prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.
Drug Mechanism
- Multi-system Inflammatory State is a Covid-19 related illness that causes inflammation of the blood vessels leading to low blood pressure, affecting the entire body as it causes a build-up of fluid in the lungs and other organs.
- The inflammation can be fatal so steroids and other anti-inflammatory drugs are used to reduce it.
- Dexamethasone is not an anti-viral but works to modulate the immune response of the body when confronted by a viral infection such as Covid-19.
Benefits
- The survival benefit is clear and large in severe patients.
- It is highly affordable, easy to make, can be scaled up quickly and only needs a small dosage.
- It is a cheaper option than tocilizumab, an injectable, which is also being tested.
Concerns
- The WHO advises that steroids should not be used early in a course of illness because they can slow the time until patients clear the virus.
- Excessive use of steroids can lead to adverse reactions like major mood swings, aggression and irritability, delusions, kidney/liver damage, increased blood pressure, etc.
India’s Reaction
- Indian doctors have welcomed the research as good news for Covid-19 patients on ventilators.
- The drug is affordable and easily available in India.
- Earlier, the Indian Council for Medical Research (ICMR) revised the protocol for clinical management of Covid-19 and allowed the use of remdesivir, tocilizumab and Convalescent Plasma Therapy (CPT) on certain groups of patients.
- Remdesivir reduced hospital stays for very sick Covid-19 patients but has not been shown to improve recovery itself.
Other Findings from the Research
Earlier, the same study showed that the malaria drug hydroxychloroquine was not working against the coronavirus.
The study enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either standard of care or that plus one of the treatments mentioned below:
- Dexamethasone.
- HIV combo drug lopinavir-ritonavir.
- Antibiotic azithromycin.
- Anti-inflammatory drug tocilizumab.
- Plasma from people who have recovered from Covid-19 that contains antibodies to fight the virus.
