Wednesday, 03 March, 2021


WHO Relents, Changes Guidelines to Use Steroids in Severe Covid-19 Cases

COVID-19 ward Corticosteroids Improve Survival in Critically Ill COVID-19 Patients, International Adaptive Randomized Trial Finds
Patty Aguilar | 04 September, 2020, 20:30

As the health and human toll grows - over 26 million infected and 863,000 lives lost, the economic damage is already evident. Dexamethasone appeared to be the most effective of the group.

Dr Ian White, consultant intensivist and anaesthetist and principal investigator for the trial at Ashford and St Peter's Hospitals NHS Foundation Trust said: "This trial has shown a dynamic approach to patient care during the pandemic".

A different study, called the RECOVERY trial, was also investigating whether another type of steroid, called dexamethasone, helped improve recovery of patients with COVID-19. They had been proposed as potential COVID-19 treatments partly because patients who die from the disease often succumb to overreactive immune responses.

The meta-analysis, which looked at data from seven studies conducted between February and June, found consistent benefits using steroids like dexamethasone, hydrocortisone, and methylprednisone.

In the hydrocortisone study, 403 COVID-19 patients who required respiratory or cardiovascular support (such as mechanical ventilation or blood pressure drugs) were split into three groups: one group was treated with a dose of hydrocortisone four times a day for a week, another got no hydrocortisone, and the third was treated only if their blood pressure dropped.

There were 222 deaths among patients given steroids and 425 deaths among those who didn't receive them, corresponding to "an absolute mortality risk of 32% with corticosteroids compared with an assumed mortality risk of 40% with usual care or placebo", the researchers concluded in their study published Wednesday in JAMA Network.

In the meta-analysis supported by World Health Organization, researchers pooled data from seven randomized clinical trials that evaluated corticosteroids-dexamethasone, hydrocortisone, or methylprednisolone-in 1,703 critically ill COVID-19 patients. The guidance was thus informed by combining data from all these randomised trials of systemic corticosteroids for COVID-19.

Because the dexamethasone study showed positive results, the hydrocortisone steroid study stopped recruiting patients on 17 June.

The findings have led to the World Health Organization updating its treatment advice to include the use of corticosteroids in severely ill patients.

The apex global public health agency has said that there are ongoing uncertainties about covid-19 treatment modalities and there are opportunities for future research.

Death rates fell by more than 20 per cent among intensive care patients treated with hydrocortisone and dexamethasone. It's the most solid news we've had yet on how to take care of patients with COVID-19. Doctors use corticosteroids to tamp down on overactive immune systems and reduce inflammation, which can help with a variety of conditions including asthma and skin disorders.

Data from the New York Times shows that Guam and 15 states-Alabama, Connecticut, Iowa, Kansas, Kentucky, Minnesota, Montana, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, and West Virginia-saw their average daily numbers of newly reported coronavirus cases rise over the past 14 days.

Scientists from Brazil, Canada, China, France, Spain, the United Kingdom and the US were involved in the study. India and Russian Federation report high case tolls, with more than 3.85 million and 1 million cases, respectively.

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