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A meta-analysis study, gathering evidence from seven clinical trials conducted in 12 countries, including Brazil, confirmed that corticosteroid medications reduce mortality from COVID-19 in critically ill patients.
A look for, published this Wednesday 2 in the prestigious scientific journal Journal of the American Medical Association (Jama), evaluated the use of three drugs in this class: dexamethasone, hydrocortisone, and methylprednisolone. Corticosteroids are low-cost anti-inflammatory drugs that have been used for decades mainly in the treatment of inflammatory, respiratory and allergic diseases such as asthma and arthritis.
The studies analyzed had the participation of 1,700 patients. All clinical trials were randomized, that is, the participants in each group (who received the drug and the control group) were chosen by lottery. In the group that took one of the corticosteroids, 32% of the patients had died after the 28-day follow-up period. Among patients who only received standard clinical support, mortality in the period was 40%, equivalent to a 20% lower risk of death among patients who received the medication.
Research also notes that corticosteroids have been shown to be safe, without an increased risk of serious side effects. “Adverse events varied between studies, but there was no evidence that the risk of serious adverse events was higher in patients treated with corticosteroids, except in the two smaller studies, where the total number of serious adverse events was 1 and 3 “. , highlights the published article.
The meta-analysis was carried out by a working group formed by the World Health Organization (WHO) to give a quick answer on possible treatments for covid. The group has scientists from all over the world, including Brazil.
Among the studies that were considered in this meta-analysis are a search coordinated by the main Brazilian private hospitals that demonstrated that dexamethasone was able to reduce intubation time in critically ill patients.
Brazilian researchers warn that the benefit and safety of corticosteroids are valid for critically ill patients with covid, who need respiratory support. For mild or early conditions, the drug has no proven benefit and may even make the condition worse.
“Corticosteroids will not cure the disease or fight the virus, they will modulate the body’s inflammatory response to combat an overreaction. Only this response, at the beginning of the infection, is the one that fights the virus. It only becomes harmful if you go wild. If you block it at the beginning, it can increase the duration of symptoms, ”explains Luciano Cesar Pontes Azevedo, teaching superintendent of Hospital Sírio-Libanês, member of the executive committee of Coalizão Covid-19 Brasil and one of the authors of the study.
The new evidence reaffirms the findings of a study of the Oxford University (UK) published in June, in which dexamethasone was able to reduce the number of deaths among intubated patients by a third. According to research published Wednesday, the company should reveal new recommendations on the use of corticosteroids.
On Wednesday, the WHO published official recommendations for the use of steroids such as dexamethasone and hydrocortisone to treat critically ill patients with the new coronavirus. “We recommend systemic corticosteroids for the treatment of COVID-19 patients in a critical and critical condition. We suggest not using corticosteroids to treat non-severe COVID-19 patients,” the organization said in a note.
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