Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalised patients. Results were announced on 16 June 2020 and researchers said they would publish them soon. The study is a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care.
  1. The observation was based on a clinical trial called RECOVERY (Randomised Evaluation of COVid-19 therapy) to test potential treatments for Covid 19, including a steroid treatment with low-dose dexamethasone.  
  2. The drug was given either orally or through an IV. After 28 days, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients.
  3. Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection. 
  4. This overreaction can prove fatal, so doctors have been testing steroids and other anti-inflammatory drugs in such patients. 
  5. The World Health Organization advises against using steroids earlier in the course of illness because they can slow the time until patients clear the virus.
  6. Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.
  7. This is the same study that earlier this month showed the malaria drug hydroxychloroquine was not working against the coronavirus. 
  8. Other methods of treatment in the ongoing trial includes the HIV drug Lopinavir-Ritonavir, antibiotic Azithromycin, anti-inflammatory treatment Tocilizumab, and Convalescent plasma. 
  9. Hydroxychloroquine, the malaria drug promoted by US President Donald Trump, has been stopped due to lack of efficacy.
  1. Dexamethasone is listed as the performance-enhancing steroid in the World Anti-Doping Agency's (Wada) 2019 list of prohibited drugs and has been described as a "specified substance" attracting punishment if found in a sportsperson's body system. 
  2. On the Wada's website under the 'prohibited in-competition substances' category, Dexamethasone is listed as a 'glucocorticoids' which are prohibited when administered by oral, intravenous, intramuscular or rectal routes.
  3. Apart from Dexamethasone, the other glucocorticoids include Betamethasone, Budesonide, Cortisone, Deflazacort, Fluticasone, Hydrocortisone, Methylprednisolone, Prednisolone, Prednisone and Triamcinolone.