Hospital Dr News

Dexamethasone reduces death in hospitalised patients with severe Covid-19

A cheap and widely available steroid has reduced deaths by one-third in ventilated patients suffering from Covid-19, a study finds.

Results from the Recovery Trial show that Dexamethasone show that as well as cutting a third of deaths in ventilated patients, it also reduces mortality by one fifth in other patients receiving oxygen only.

Drug trial findings are usually published in a medical journal after being peer-reviewed by other experts but that takes time.

The investigators in this study said that as soon as it became clear that the results were so significant that they had to go public.

The UK already has a stockpile of 200,000 doses that are “ready to go” for NHS patients.

In March 2020, the Recovery Trial was established as a randomised clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone.

Over 11,500 patients have been enrolled from over 175 NHS hospitals in the UK.

On 8 June, recruitment to the dexamethasone arm was halted since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.

A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone.

Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said: “Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result.

“The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.

The UK Government’s Chief Scientific Adviser, Sir Patrick Vallance, said: “This is a ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable.

“It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.”

The study showed there was no benefit among those patients who did not require respiratory support.

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