Repurposed corticosteroid dexamethasone shown to reduce mortality in COVID-19 patients needing respiratory support
The University of Oxford has unveiled exciting new data in the treatment of the novel coronavirus, with a randomised clinical trial proving the efficacy of the corticosteroid dexamethasone in reducing mortality rates in COVID-19-infected patients requiring respiratory intervention
In the study, 2,104 participants were randomised to receive 6mg dexamethasone either intravenously or orally for ten days, while 4,321 were randomised to receive only usual care. In this latter group, patients requiring ventilation saw the highest rate of 28-day mortality at 41%, followed by 25% in participants requiring oxygen, and 13% in patients who did not require respiratory intervention.
In the dexamethasone group, across these same patient populations, mortality rates were reduced by a third in patients requiring ventilation to 28%, and by a fifth in patients requiring oxygen, down to 20%. No benefit was recorded in patients who were not in need of respiratory support.
An already widely available and cheap therapy, dexamethasone was shown to reduce inflammation which can lead to severely ill patients experiencing a cytokine storm, a leading cause of mortality in those with COVID-19.
“Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result,” commented Peter Horby, one of the Chief Investigators on the trial and Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford. “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.”
Martin Landray, another Chief Investigator and Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, added: “Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”
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