Researchers have been working hard to find treatments to help reduce the mortality rate and stop the spread of COVID-19. Preliminary research from a randomized clinical trial in the United Kingdom suggests that a drug may have finally been found that will help patients in serious condition. If the results are confirmed, the drug, a steroid called dexamethasone, will be the first drug known to improve COVID-19 survival rates.
The RECOVERY Trial includes over 11,500 patients in over 175 of the United Kingdom’s NHS hospitals. The trial is testing the effectiveness of a variety of drugs in the treatment of COVID-19. Their dexamethasone trial, which stopped recruiting on June 8 when the steering committee decided that enough patients were enrolled to determine whether or not the drug was effective, showed success in improving survival rates among patients on ventilators or supplementary oxygen.
For the dexamethasone trial, 2,104 patients received six milligrams of dexamethasone once per day, either orally or intravenously, for 10 days. These patients were compared to 4,321 patients receiving the usual hospital care. For the patients receiving the drug, deaths were reduced by one-third for patients on ventilators and one-fifth for patients on supplementary oxygen. No benefit was seen in patients not on respiratory support.
This data means that Dexamethasone would prevent one death for every eight people on ventilators and one death for every twenty-five people on supplementary oxygen. Although the current data is only preliminary, if the results of dexamethasone use are confirmed, it will greatly benefit the fight against COVID-19 because the drug is inexpensive and widely available. While this is exciting news, many doctors are reserving their excitement until more data is available.
Because steroids are used to suppress the immune system response, they can make viral infections worse. If the immune system overreacts as it tries to fight the infection, it can cause dangerous inflammation which could be reduced by a steroid. The CBC reported that Dr. David Juurlink, head of clinical pharmacology at the University of Toronto, suspects that dexamethasone reduces inflammation in the lungs. This allows patients with respiratory complications, such as those on ventilators and supplementary oxygen, to breathe better.
In the RECOVERY Trial’s statement, which was released June 16, they say that they “are now working to publish the full details as soon as possible” because of the importance that any treatment method for COVID-19 has for public health.
Peter Horby, a professor in the Nuffield Department of Medicine at the University of Oxford and one of the study leaders is excited by the preliminary results. In the statement he said that “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.”
Dr. Theresa Tam, Canada’s chief public health officer said that Canada “will look with great interest towards the actual publication of this randomized control trial” and added that “it’s very important for us to actually examine the results very carefully before making any further recommendations.”
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