In several recent studies from the University of Michigan and elsewhere, researchers found steroids can fight severe COVID-19.
They showed that common drugs known as corticosteroids (e.g., hydrocortisone or dexamethasone) appear to cut the COVID-19 death rate by a third.
The findings suggest an important step forward in the treatment of patients with COVID-19.
The study findings are published in JAMA. One author is Dr. Hallie Prescott of the University of Michigan.
One of these studies was a “meta-analysis”—a review of data looking at the combined results of seven different clinical trials.
Those trials involved more than 1,700 critically ill COVID-19 patients treated at medical centers in 12 countries.
The team showed that the use of corticosteroids in the care of these patients cut the death rate by about one-third.
This finding was true for patients requiring mechanical ventilation as well as those who required supplemental oxygen but not a ventilator.
How might corticosteroids help save lives threatened by COVID-19?
The team says these drugs work to counter the runaway inflammatory response—”cytokine storm”—that can drive late-stage COVID-19 and overwhelm patients’ defenses.
In addition, many patients treated for COVID-19 in the intensive care unit (ICU) require ventilators to breathe because they develop a condition known as acute respiratory distress syndrome (ARDS).
ARDS is often seen in advanced cases of pneumonia and other illnesses, and can easily prove fatal.
Previous studies had found that corticosteroids seem to have value in the treatment of patients” with severe pneumonia and ARDS.
In June, the first solid evidence that the drugs might fight COVID-19 also emerged, with the publication of results from a British trial of more than 6,400 patients.
That study found that the use of dexamethasone cut the death rate by about one-third for patients on ventilators, and by about one-fifth for those requiring supplemental oxygen.
In other studies, researchers working on three new clinical trials found preliminary results indicating that corticosteroids would help against COVID-19.
One study from Brazil tested 299 patients treated in ICUs. It found that adding dexamethasone to treatment resulted in a strong increase in the number of ventilator-free days over 28 days of treatment.
Two other studies—one from France and the other including American patients—also suggested real improvement from the use of corticosteroids.
The U.S. study involved 403 COVID-19 patients treated in an ICU between March and June.
It found a 93% probability that adding intravenous hydrocortisone to patients’ treatment would end in better outcomes.
The team says it is relatively rare in medicine that scientists find drugs where the evidence of their effectiveness in saving lives is so consistent.
This is could be the single clearest answer scientists have had so far on how to manage terribly ill COVID-19 patients.
People on ventilators or oxygen and under intensive care should definitely be given corticosteroids.
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