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Cheap steroids can save the lives of patients who are seriously ill with Covid-19, studies show.
The findings confirm the results of an earlier trial, which has already led to steroids being widely used in Covid patients in intensive care.
The new results, published in JAMA, show that eight lives would be saved for every 100 patients treated.
The researchers said the findings were impressive, but stressed steroids were not a cure for the coronavirus.
- What advances are we making in treatments?
In June, the UK Recovery trial found the first drug, a steroid called dexamethasone, that could save the lives of people with severe Covid.
The latest study brings together all the clinical trials involving steroids in coronavirus patients around the world.
It confirms that dexamethasone works and that another steroid, hydrocortisone, is just as effective.
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“At the beginning of the year, sometimes it felt almost desperate to know that we did not have specific treatments,” said Professor Anthony Gordon of Imperial College London.
“It was a very concerning moment, however, less than six months later, we found clear and reliable evidence in high-quality clinical trials of how we can address this devastating disease.”
The results of 1,703 critically ill patients showed:
- 40% died when only standard treatment was given
- 32% died when steroids were administered
The studies were conducted only in the sickest hospital patients. Most people recover having only mild symptoms.
Steroids calm inflammation and the immune system, which is why they are already used in conditions such as arthritis and asthma, as well as some serious infections.
The drugs are not believed to be helpful in the early stages of a coronavirus infection, when symptoms include a cough, fever, or sudden loss of taste or smell.
But as the disease develops, the immune system can ramp up and damage the lungs and other organs.
It is at this stage of Covid that steroids are believed to help.
“By the time you reach for an oxygen cylinder for a Covid patient, you should probably look for the prescription for corticosteroids,” said Professor Martin Landray of the University of Oxford.
“These results can be used instantly; they are cheap, well-known and widely available drugs that reduce mortality.”
Doctors are already using dexamethasone after results earlier in the year, but the hope is that having a choice of different drugs will increase access to treatment worldwide.
Medicines can be swallowed as tablets or given through an IV drip.
Research so far has focused on low-dose steroids. There is no evidence that higher doses are more effective.
The World Health Organization is expected to publish new guidelines for physicians.
In the UK, NHS Executive Director Sir Simon Stevens said: “As we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from hydrocortisone treatment do so, adding a weapon more in the arsenal of the global fight against Covid-19 “.
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