UK: Steroid to reduce deaths in critical virus patients
05 September, 2020, 08:10
Hydrocortisone, like other steroids, is an anti-inflammatory.
The study evaluated hydrocortisone in 403 patients with suspected or confirmed COVID-19, who required respiratory or cardiovascular organ support.
In an editorial accompanying the analysis, Hallie Prescott, a professor of medicine at the University of MI, and Todd Rice, a professor of medicine Vanderbilt University, wrote, "The consistent findings of benefit in these studies provide definitive data that corticosteroids should be first-line treatment for critically ill patients with Covid-19". The finding showed that corticosteroids might help reduce the risk of death among patients with severe COVID-19.
The JAMA study did the meta-analysis on seven randomised trials that included 1,703 patients.
Researchers said the benefit was shown regardless of whether patients were on ventilation at the time they started treatment. Overall, it found that patients on placebo or usual care had about a 41 per cent absolute risk of dying within 28 days, while those on steroids had a 33 per cent absolute risk of dying. However, a recent study also showed that patients on a 10-day course of remdesivir died at about the same rates as people given other treatments. Lung inflammation is a major issue among patients with serious COVID-19 cases, often requiring oxygen support to counter the resulting breathing difficulties.
Eighteen percent of patients on steroids reported side effects compared to 23 per cent of patients on usual care or placebo.
New research released Wednesday seems to confirm one of the few hopeful discoveries made during the covid-19 pandemic: Cheap steroid drugs can save the lives of people with severe covid-19.
Although evidence is continuing to grow of the effectiveness of steroids in treating hospitalised patients, the World Health Organization has cautioned against their use for individuals with mild symptoms, saying that "indiscriminate use of any therapy for Covid-19 would potentially rapidly deplete global resources and deprive patients who may benefit from it most as potentially life-saving therapy". That means if you treat 100 patients giving them steroids, you would expect to save eight lives.
Still, many groups, including NIH andthe Infectious Diseases Society of America, and providers are recommending the use of steroids to treat severely ill, hospitalized Covid-19 patients-with caution.
However, the randomised studies done till now offer good results in using corticosteroids among critical COVID-19 patients.
Following the release of WHO's new analysis, Nahid Bhadelia, medical director of the Special Pathogens Unit at the Boston University School of Medicine, said, "It still remains unclear if there is any use in starting [steroids during] earlier [stages of Covid-19]". The study did find that the steroid treatment did not help less sick patients and might even have been harmful to those with less severe cases.
Corticosteroids are a class of drugs that suppress out-of-control immune-system responses.
Based on this analysis, the Geneva-based United Nations health body, which has been monitoring the pandemic situation, has updated its treatment guidelines to recommend that systemic corticosteroids can be used to treat severe and critical COVID-19 patients.
The seven trials involved 1,703 critically ill patients located worldwide and the beneficial effect of corticosteroids was irrespective of people's age, gender or how long they had been ill.
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