The steroid dexamethasone has been shown to significantly reduce the risk of death in patients with severe coVID-19 at a low cost, according to a study by the University of Oxford.
Dexamethasone has been officially approved for use by the National Health Service (NHS) in the treatment of patients with covid-19 who need oxygen and ventilators, the Department of Health announced on Monday.
But experts questioned how to deal with the serious side effects of dexamethasone, which has not been published and has not been peer-reviewed, and called for caution.
A recent Study from Oxford University found that dexamethasone significantly reduced the death rate of patients using respirators by about a third and those on oxygen by about a fifth when treating COVID-19.
The news caused a stir. The British Prime Minister Johnson said at the epidemic briefing on the 16th that the drug was “the biggest breakthrough to date” in the treatment of novel Coronavirus, and the Department of Health announced on the 16th that it would be approved to use Dexamethasone in the treatment of patients by NHS with immediate effect.
It can reduce the mortality rate of critically ill patients by 1/3
Dexamethasone, a synthetic corticosteroid, has been used extensively to treat severe allergies, asthma and other conditions for more than 60 years.
In a clinical trial supported by the British government, the team compared about 2,100 patients with severe coVID-19 who received dexamethasone with about 4,300 who received only routine treatment.
The risk of death dropped from 40 percent to 28 percent in patients on the ventilator.
The risk of death for patients requiring oxygen also dropped from 25 percent to 20 percent after treatment.
Professor Peter Horby, of The University of Oxford and the lead researcher on the project, said dexamethasone was “the only drug” so far proven to reduce mortality in people with severe coVID-12 and was so effective that he called for it to become standard treatment for these patients.
But he stressed that dexamethasone was not helpful in mild cases, only in severe cases requiring respiratory support.
The stockpile is enough to treat 200,000 people
Dexamethasone, on the other hand, is widely available around the world, and its immediate use, coupled with its low price, can further reduce the burden on poor countries.
The treatment costs less than ￡5 a day for each patient and lasts 10 days, meaning ‘less than ￡50 (HK $485) can save a life’, said Oxford University professor Landre.
Another researcher said 5,000 lives could have been saved if the drug had been used in the UK at the time of the initial outbreak.
The British government has restricted the export of dexamethasone, a drug that Health Secretary Charles Xia said “can help us turn the tide of the epidemic”, and revealed that the government had been stockpiling dexamethasone for months and that it now has enough to treat 200,000 people.
Who Director-General Tedros Adhanom Ghebretzer described dexamethasone treatment for COVID-19 as “significant news” and said who would conduct a comprehensive analysis of research data in the future to update medical guidance on how and when to use dexamethasone.
Steroid use is controversial
However, many experts urged caution over the findings.
Scientists are eager to determine a treatment for coVID-19, but in recent months several drugs labeled coVID-19 have sparked controversy over their efficacy and safety.
On the 15th, the US Food and Drug Administration (FDA) withdrew emergency authorization for the antimalarial drugs hydroxychloroquine and chloroquine;
Earlier this month, the Lancet also retracted a research paper on hydroxychloroquine because of data falsification.
At present, the dexamethasone researchers have only released a press release. The complete paper has not yet been published or reviewed, and further research and data are needed to confirm the validity of the findings.
University of Washington medical professor Markufer urged researchers to release the data as soon as possible to determine when to use the treatment.
The use of steroids in the treatment of respiratory viral infections has been controversial.
Experts point out that steroids block the body’s over-immune response to the virus, not the virus itself.
In the past, when treating SARS and MERS, several studies have shown that steroids can damage patients’ immune systems.
According to the UK’s National Institute for Health and Care Excellence (NICE), common side effects of steroids include osteoporosis, sleep disorders and even eye disease, heart failure and epilepsy.