- Corticosteroids are a class of drugs designed to suppress the immune system’s responses out of control.
- They could improve survival rates for patients with severe cases of CIVID-19, according to new research.
- The World Health Organization issued a “strong recommendation” for the use of steroids in critically ill patients based on the results of seven clinical trials.
- Steroids are cheaper and more readily available than remedivir, the only other drug that has been shown to promise treatment for severe COVID-19 cases.
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Corticosteroids – the cheapest and most widely available class of drugs – can help people with severe cases of COVID-19 survive, according to trial results published this week.
A strong analysis looking at seven trials of corticosteroids found that when patients on a ventilator were treated with steroids, they were 38% more likely to die than patients who did not take steroids. For patients treated without a ventilator, the benefit was greater: there was a 23% chance of death in those given steroids, compared to a 42% chance for those in the control group.
“This is about 68% [the sickest COVID-19] In the absence of corticosteroids after corticosteroid treatment, about 60% of patients survive compared to those who survived, the researchers said.
Steroids in the trial included methylprednisolone, hydrocortisone and dexamethasone.
World Health Organization headquarters in Geneva.
Reuters
Based on the results, the World Health Organization issued a “strong recommendation” on Wednesday that doctors prescribe dexamethasone or hydrocortisone to critically ill COVID-19 patients. However, the organization does not recommend steroids for people who are not seriously ill.
Corticosteroids can suppress the immune system
Corticosteroids are synthetic hormones that mimic cortisol, a hormone that helps the body naturally regulate metabolism, the immune system and the stress response. Doctors use corticosteroids to tamper with overactive immune systems and reduce inflammation, which can help with a variety of conditions, including asthma and skin disorders.
Coronavirus can stimulate hypersensitive immune responses, which can be fatal. When too many blood cells flood the bloodstream, some viruses invade healthy tissues in addition. Steroids can help suppress that type of dangerous immune response in COVID-19 patients.
Scientists at Oxford University discovered in June that dexamethasone, in particular, improves the survival rate of patients, but at the same time, experts and international organizations are seeking more evidence before making recommendations. Now they have.
Dr. Editor-in-Chief of the Journal of the American Medical Association. “Clearly, steroids are now the standard of care,” Howard Bouchner told the New York Times. “
Corticosteroids are cheaper than remedesivir and Can be more effective
Ramdesivir is the only other drug that has been found to be effective for the treatment of critically ill COVID-19 patients through rigorous testing. In May, a study found that remedizivir shortened recovery time for those patients. However, a recent study also showed that patients with a 10-day course of rimdasivir died at the same rate as other treatments.
Corticosteroids, then, promise more.
“I had a big smile on my face when I got the results,” Dr. Derek Angus, president of the Department of Critical Care Medicine at the University of Pittsburgh and co-founder of a trial, told the Times.
The National Institutes of Health now recommends corticosteroids, especially dexamethasone, COVID-19 for patients who need a ventilator or supplemental oxygen.
The added benefit of corticosteroids is that they are cheaper. A 6- to 10-day course of dexamethasone treatment is likely to cost customers between 10 and 13 days, said Michael Ray, CEO of MX Savings Solutions, which sells software designed to help people choose less expensive drugs.
In contrast, remedial manufacturer Gilead Sciences has said it will charge governments in developed countries 2, 2,340 for a five-day course in medicine.
However, steroids can have side effects
Some side effects of corticosteroids can occur, especially in elderly patients. Medications can make people more susceptible to other infections and increase the risk of high blood pressure, glaucoma, weight gain and delirium.
They do not appear to be effective even in less-severe cases. In the Oxford trial, for example, patients with mild cases who took dexamethasone died at a slightly higher rate than patients with mild cases who did not take the drug.
That is why the WHO and the National Institutes of Health do not recommend steroids for patients who are not seriously ill. But for most fatal cases, the pros look better than the pros.
