Cheap, widely available steroid drugs were shown to reduce the risk of death in some patients.
By Jonathan Wolfe and Lara Takenaga
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Treatment for the severely ill
Seven months into the coronavirus crisis, scientists have confirmed the efficacy of a powerful weapon in the battle against Covid-19. In international trials published today, cheap, widely available steroid drugs were shown to reduce the risk of death in seriously ill patients. Until now, the only other drug shown to help seriously ill patients, and only modestly, was remdesivir.
Many patients who are infected do not die from the virus, but from the body’s overreaction to the infection. The new research includes three studies and an analysis of pooled data from seven randomized clinical trials, which confirmed that steroids like dexamethasone, hydrocortisone and methylprednisolone can tamp down the body’s immune system and reduce the risk of death.
The strongest results were from dexamethasone, which produced a 36 percent drop in deaths; hydrocortisone appeared to reduce deaths by 31 percent; and a small trial of methylprednisolone showed a 9 percent drop. The results were so strong that the World Health Organization issued new treatment guidance and strongly recommended the use of steroids to treat severely and critically ill patients.
The W.H.O. warned against using steroids indiscriminately, noting that patients who are not severely ill are unlikely to benefit and may suffer side effects. Steroids, especially in older patients, can cause confusion or even delirium, and may leave them vulnerable to other infections. Further, wide use could deplete global supplies, depriving patients who genuinely need the medications.
But taken together, the studies “are like the second punch of a one-two punch,” said Dr. Derek C. Angus, an author of one of the new studies and the analysis. “I had a big smile on my face when I saw the results.”
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