COVID-19: Dexamethasone Should Not Be Administered at the Beginning of the Disease

Last June, a study showed the effectiveness of Dexamethasone in reducing mortality in severe cases of COVID-19 and the extensive results of this research suggest that it should be reserved for patients that need respiratory support.

Dexamethasone

Dexamethasone

Dexamethasone is a corticosteroid used for its anti-inflammatory properties. It has been used in medicine since the 1960s. Last June, the British recovery study announced that it had reduced mortality of COVID-19 patients by one-third. The researchers are publishing all their results in the New England Journal of Medicine. They stipulate that the treatment should be reserved for patients at an advanced stage of the disease.

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Significantly lowers mortality rate

The study included over 6,000 participants, 2,104 of whom took the drug. In patients who received mechanical ventilation, the mortality rate after 28 days was 29.3% when they received dexamethasone, compared to 41.4% for the others. Conversely, the mortality rate was higher in patients receiving this treatment if they were not on a ventilator. Researchers found better results in patients who had been symptomatic for at least seven days.

This drug is an immunosuppressant, i.e. it blocks the action of the immune system, so it should not be administered at the beginning of the disease, but only when there is a too strong immune response that can cause severe inflammation.

A medicine approved by the WHO

The World Health Organization welcomed the results announced in June. “This is great news,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a statement. This is the first time that a treatment has been shown to reduce mortality in COVID-19 patients who need oxygen or mechanical ventilation”. he also called for increased production of the drug in order to successfully market it worldwide.

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Two treatments show positive results

Numerous studies worldwide aim to find an effective treatment for COVID-19. To date, dexamethasone is only one of two drugs that have proven to be effective. The second drug Remdesivir, an antiviral, reduces the length of hospital stay for patients with this disease by about 4 days. Studies on hydroxychloroquine were discontinued in Europe in June due to the cardiovascular risks to patients. Trials combining two antiviral drugs, lopinavir/ritonavir, were also discontinued due to adverse effects on kidney function.

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References

Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19

Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report

WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients

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