Steroids Show Promise for Very Serious Covid Cases

A ventilator helps a COVID-19 patient breath inside the Coronavirus Unit at United Memorial Medical Center in Houston. (AP Photo/David J. Phillip)

(CN)— Steroids reduced the risk of death for critically ill Covid-19 patients by about 10%, according to a World Health Organization analysis published Wednesday in the Journal of the American Medical Association.

The WHO analyzed seven randomized trials held in 12 countries, encompassing 1,703 patients hospitalized with critical conditions from Covid-19. The trials involved steroids that mimic the hormone cortisol, called corticosteroids.

The novel coronavirus Sars-Cov-2 was first discovered in Wuhan, China, at the end of December 2019. Since then, 25.8 million people worldwide have been diagnosed with the virus that causes Covid-19 and an estimated 858,000 have died from the disease. Covid-19 is currently the third leading cause of death in the United States.

Research published earlier this year from the United Kingdom’s RECOVERY trial also found low doses of dexamethasone lowered the death rate of patients with Covid-19 on ventilators.

All in all, the WHO found that 32% of the 678 patients given corticosteroids died during the study, compared to a 41% death rate among the 1,025 patients given placebos or usual care.

Besides low and high doses of dexamethasone, hospitals also treated Covid-19 patients with low doses of hydrocortisone and high doses of methylprednisolone.”

The analysis found 70% of patients given dexamethasone and 68% who were given hydrocortisone survived, compared to 60% of patients who were not prescribed the corticosteroids.

“These trial results from diverse clinical and geographic settings suggest that in the absence of compelling contraindications, a corticosteroid regimen should be a component of standard care for critically ill patients with Covid-19,” the WHO Rapid Evidence Appraisal for Covid-19 Therapies Working Group concluded in the report.

According to the organization, most corticosteroid trials have stopped recruiting patients “because equipoise for withholding corticosteroids was no longer present.”

Although the researchers have not determined an ideal dosage, early evidence suggests larger doses do not offer better results. In fact, death rates among patients given low doses of the corticosteroids hit 29%, compared to a 36% risk of death for those who received higher doses.

Interestingly, corticosteroids have been linked to a higher death rate in patients hospitalized with influenza.

Most patients in the study were on ventilators and less than half were given vasoactive agents to regulate blood pressure. While the corticosteroids appeared to help patients on ventilators, fewer patients receiving vasoactive agents and corticosteroids survived.

Patients in the study ranged from 52 to 68 years old. Nearly a third of patients were women. All participants were hospitalized between February and June.

Because most survivors were discharged from the hospital, researchers reported they were unable to determine long-term effects of this regimen. The impacts on children also remain largely unknown.

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