Is dexamethasone safe to use in Covid-19 patients? A study found that dexamethasone can reduce deaths by up to one-third of 6,000 severely ill patients.
According to a team of researchers in England, dexamethasone is promising in terms of ensuring the survival of Covid-19 patients.
In the study, more than 2,100 patients took dexamethasone, which is a common steroid known for curing inflammation.
The British government authorized the use of dexamethasone among some patients. However, the benefits of the treatment for less severe COVID-19 cases are still not clear. In addition, the study has not been peer-reviewed or used in other studies.
“This is a significant improvement in the available therapeutic options that we have,” said Dr. Anthony Fauci, the United States’ top infectious disease expert.
Gucoocorticoid
Dr. Onyema Ogbuagu, an infectious disease doctor and associate professor of medicine at Yale, finds dexamethasone because it is a glucoocorticoid.
Dexamethasone is known as an oral or intravenous steroid. It is also a general purpose anti-inflammatory and anti-swelling drug used for different conditions.
According to Dr. Robert Glatter, an emergency physician at New York City's Lenox Hill Hospital, dexamethasone also has a half-life of up to 54 hours. This helps "to assure a therapeutic level of medication to treat ongoing inflammation."
However, dexamethasone "is a non-specific treatment not necessarily targeting a single, specific pathway of inflammation or swelling," according to Ogbuagu.
10 days
Ogbuagu pointed out that Covid-19 comes in two phases.
"People get the virus, it replicates, and that's the first phase of the illness," he noted. "Afterward, around 10 days into the infection, people start to produce antibodies and inflammatory reactions to the virus."
The inflammatory chemicals can sometimes lead to Covid-19 complications, like acute respiratory distress syndrome. This does not make it easy for oxygen to reach the bloodstream and the organs.
Individuals with severe Covid-19 experienced significant benefits with dexamethasone in the UK study. The patients was treated with the steroid for 10 days, either orally or via IV.
It had cut deaths by 35% in patients in a month. These patients needed treatment with breathing machines and by 20% in those requiring supplemental oxygen.
Ogbuagu says some studies suggest that steroids such as dexamethasone can help improve mortality rates among people with ARDS.
Complications
According to Ogbuagu, factors like timing and selectiveness among patients are important in ensuring the use of dexamethasone as a treatment for Covid-19.
Results of the study suggest that Covid-19 patients who do not show severe symptoms, such as requiring a respirator, must not receive dexamethazone.
"The downside of steroids is that it's not selective," Ogbuagu said. "It's a double-edged sword that may hinder your body's ability to fight the virus."
He stressed that some studies determined higher mortality rates in people who took steroids, since they have the body's immune response to the virus.
The World Health Organization and other organizations do not recommend using steroids earlier in the phase of illness because they can obstruct clearing the virus.
Ogbuagu added that steroids may lead to some severe side effects, including new or worsening diabetes, psychosis, or emotional disturbance.
