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Dexamethasone could reduce death rates in hospitalised COVID-19 patients

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A study from early in the global coronavirus pandemic that evidenced the benefits of using steroids to combat COVID-19 in severely ill patients could have saved lives, according to the University of Huddersfield researchers involved.

Dr. Hamid Merchant and Dr. Syed Shahzad Hasan assessed the results of using corticosteroids such as dexamethasone on hospitalized COVID-19 patients with acute respiratory distress syndrome (ARDS) who were on respiratory support.

By mid-April they had found that the proportion of COVID-19 patients who died in the steroid group was significantly lower compared to those who did not receive corticosteroids, at 28 percent vs. 69 percent. Their research has now been published in the Expert Review of Respiratory Medicine following a lengthy period of scrutiny and peer review.

The Huddersfield academics’ work highlights the issues involved in scrutinizing scientific evidence, as well as costs involved in research and the UK’s preference for evidence-based practice. Oxford University’s RECOVERY trial came to similar conclusions as the Huddersfield researchers in mid-June, leading to the UK government’s decision that dexamethasone could be made available to patients, a move being followed around the world.

Benefits of steroids outweigh the risks

The World Health Organization (WHO) had, early in the pandemic, recommended that steroids should not be used to combat COVID-19 due to perceived risk of delayed coronavirus clearance. Despite warnings from WHO, various global bodies acknowledged the mortality benefits of using steroids on COVID-19 patients with ARDS, such as the National Health Commission & State Administration of Traditional Chinese Medicine (NHC), Surviving Sepsis Campaign (SSC), and the National Institute of Health (NIH).

“What this shows is that providing evidence is not cheap,” says Dr. Merchant. “It comes at a very high cost; it not only costs time and money but may even cost precious lives. The background of the pandemic highlights this, it’s something that we have known for years but unfortunately has been thrown into sharp relief by coronavirus,” he adds.


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More information:
Syed Shahzad Hasan et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis, Expert Review of Respiratory Medicine (2020). DOI: 10.1080/17476348.2020.1804365

Citation:
Dexamethasone could reduce death rates in hospitalised COVID-19 patients (2020, August 18)
retrieved 18 August 2020
from https://medicalxpress.com/news/2020-08-dexamethasone-death-hospitalised-covid-patients.html

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